Medical Procedure Costs in Vermont

Vermont medical procedure costs are generally below the national average. Vermont has a single Medicare pricing locality.

Cost vs National Avg
-2.6%
Lower than average
Pricing Localities
1
Medicare pricing regions
Procedures Covered
7,500+
CPT codes with pricing

Procedure Costs in Vermont

ProcedureVermont
Incision & Drainage of Abscess$126
Skin Biopsy (Tangential)$94
Skin Biopsy (Punch)$119
Destruction of Skin Lesion$65
Partial Mastectomy$589
Total Hip Replacement$1,091
Total Knee Replacement$1,089
Knee Arthroscopy$490
Upper Endoscopy (EGD)$316
Upper Endoscopy (EGD) With Biopsy$411
Colonoscopy (Diagnostic)$369
Colonoscopy With Biopsy$470
Colonoscopy With Polyp Removal$488
Laparoscopic Cholecystectomy$586
Laparoscopic Inguinal Hernia Repair$396
Laparoscopic Removal of Ovarian Cyst$550
Vaginal Delivery (Global)$2,034
Cesarean Delivery (Global)$2,252
Lumbar Discectomy$831
Cataract Surgery$452
MRI Brain Without Contrast$192
MRI Brain With Contrast$265
MRI Brain$312
Chest X-Ray$32
CT Chest Without Contrast$130
CT Chest With Contrast$164
MRI Cervical Spine$188
MRI Lumbar Spine$189
Shoulder X-Ray$35
MRI Shoulder$202
Knee X-Ray$34
MRI Knee$201
CT Abdomen & Pelvis Without Contrast$180
CT Abdomen & Pelvis With Contrast$296
Ultrasound Abdomen$112
Ultrasound Transvaginal$116
Ultrasound Pelvis$104
Diagnostic Mammogram$154
Screening Mammogram$124
Nuclear Stress Test$422
Psychiatric Evaluation$173
Psychiatric Evaluation With Medical Services$199
Psychotherapy (45 min)$113
Psychotherapy (60 min)$166
ECG/EKG$15
Echocardiogram$194
Stress Echocardiogram$183
Carotid Ultrasound$186
Laser Treatment for Skin$136
Physical Therapy (Therapeutic Exercise)$29
Physical Therapy (Manual Therapy)$27
PT Evaluation (Low Complexity)$97
PT Evaluation (Moderate Complexity)$97
Office Visit (New, Low)$114
Office Visit (New, Moderate-High)$173
Office Visit (New, High)$230
Office Visit (Established, Moderate)$93
Office Visit (Established, Moderate-High)$133
Office Visit (Established, High)$188

Prices shown are Medicare office (non-facility) rates. Click any procedure for full details including hospital rates and savings tips.

Understanding Medical Costs in Vermont

Medical procedure costs in Vermont are determined by Medicare's Geographic Practice Cost Indices (GPCIs), which account for differences in physician work, practice expenses, and malpractice insurance across regions.

The prices listed above represent Medicare reimbursement rates, which serve as a baseline for what healthcare costs in Vermont. Private insurance companies typically negotiate rates between 130% and 200% of these Medicare amounts. If you are paying out of pocket, many providers in Vermont offer cash discounts of 20% to 40% off their standard charges.

For the most accurate pricing, enter your ZIP code on any procedure page to see costs adjusted for your specific locality within Vermont.

Ways to Save on Medical Costs in Vermont

Compare Insurance Plans

Comparing marketplace plans in Vermont could save you thousands on procedures.

Compare plans on eHealth

Try Telehealth First

Many consultations can be done virtually for $50-100, saving hundreds vs an in-person visit.

Book on Sesame Care

Save on Prescriptions

If a procedure leads to a prescription, discount cards can save up to 80% at pharmacies.

Check prices on GoodRx

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Medical Costs in Vermont: Frequently Asked Questions

How much do medical procedures cost in Vermont?

Medicare procedure costs in Vermont are generally below the national average by about 3%. For example: incision & drainage of abscess around $126, skin biopsy (tangential) around $94, skin biopsy (punch) around $119. Private insurance typically pays 130-200% of these Medicare rates and self-pay cash prices vary by provider.

Why do procedure costs vary within Vermont?

Vermont has a single Medicare pricing locality, so Medicare rates are consistent statewide. Actual charges still vary by provider and setting (office vs hospital).

What do Medicare patients pay for procedures in Vermont?

Medicare patients in Vermont typically pay 20% of the Medicare-approved amount after meeting their Part B deductible, with Medicare covering the other 80%. Supplemental (Medigap) plans can cover most of that 20% coinsurance.

How can I save on medical procedures in Vermont?

Ask each provider for a self-pay or cash price before scheduling, as many in Vermont discount 20-40% for upfront payment. If you are uninsured, compare marketplace insurance plans, use telehealth for consultations, and check prescription discount cards.

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts and may not reflect actual charges. Private insurance and self-pay estimates are approximations.