CMS Price Transparency Data

Extended office visit (prolonged)

Facility: Porter Hospital Inc

Billing Code: G2212 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G2212
Insurance Median: $34
Cash Discount Price: $72
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Extended office visit (prolonged) at Porter Hospital Inc is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $34.07, this hospital’s rate is 1.00x the Medicare baseline. Located in 115 Porter Drive, Middlebury, VT.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$34.07

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $34.07 (100%)

Cash / Self-Pay: $72 (211%)

Insurance Median: $34 (100%)

Cash: $72 (211% of Medicare)

Ins. Median: $34 (100% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $34.07 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
UnitedHealthcare	$23 - $69	68%
Mvp	$25 - $62	73%
Fidelis Care	$26	76%
Humana	$28	82%
Aetna	$29	85%
Veterans Affairs Community Care Network	$29	85%
Veterans Choice	$29	85%
Capital District Physicians' Health Plan	$30 - $49	88%
Martins Point	$30	88%
Blue Cross Blue Shield	$33 - $54	97%
Harvard Pilgrim	$34	100%
Cigna	$35	103%
Coventry	$38	112%
Wellpath	$38	112%
Medical Corporation	$66	194%
Multiplan	$66	194%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $72.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G2212.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Porter Hospital Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G2212.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.