Prostate Biopsy Cost in Vermont (2026): Average Prices & What You'll Pay
What does a prostate biopsy cost in Vermont?
The same prostate biopsy in Vermont might cost you $802 at one facility and $2,552 at another - the building you walk into drives the difference. The median cash price across 9 reporting hospitals is $999. These figures come straight from hospital price transparency files published under federal law. The sections below break this down by coverage and by insurer.
Once you have a bill or an appointment on the calendar, CostKits can help you keep it all organized.
Where prostate biopsy costs vary in Vermont
Pins show hospitals with price-transparency data (colored by vs. state average) and nearby outpatient clinics and other facilities (colored by type). Click any pin for facility name and estimated cost range.
26+ people checked prices near them this month.
What you pay for a prostate biopsy depends on where you go and what is billed separately. Most patients find out after.
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Cheapest Prostate Biopsy Providers in Vermont
Based on declared cash/self-pay prices from CMS hospital price transparency files.
| # | Facility | City | Price | vs median ($999) |
|---|---|---|---|---|
| 1 | Gifford Medical Center | Randolph, VT | $548 | $451 below |
| 2 | Mt. Ascutney Hospital and Health Center | Windsor, VT | $734 | $265 below |
| 3 | Rutland_Regional_Medical_Center | Rutland, VT | $904 | $95 below |
| 4 | University of Vermont Medical Center Inc | Burlington, VT | $999 | $0 above |
| 5 | Brattleboro Memorial Hospital | Brattleboro, VT | $1,583 | $584 above |
| 6 | Central Vermont Medical Center Inc | Berlin, VT | $3,198 | $2,199 above |
| 7 | Porter Hospital Inc | Middlebury, VT | $3,793 | $2,794 above |
| 8 | Copley Hospital | VT | $4,535 | $3,536 above |
Prices are declared self-pay rates. Contact each facility for a formal quote before scheduling.
Before you book: three questions that change the price
- Is this the self-pay price, and does it include the doctor, anesthesia and any lab or pathology? Those are often billed separately.
- Can you give me the price in writing, with the billing codes it covers?
- What happens to the price if something extra is needed during the procedure?
Estimate your out-of-pocket cost → · When the bills arrive, we check them for errors →
Quick take
- Gifford Medical Center is the lowest-cost option at $548 - $451 below the median posted price ($999), just by choosing where you go.
- Ask for the cash price if your deductible isn't met - the median cash price here is $1,291, and it's often lower than what insurance pays before your deductible is satisfied.
- Doctor offices and independent clinics may charge differently from hospitals for the same service and may not appear in this hospital-only dataset. Ask your doctor whether another site is an option.
| Coverage | Hospitals with a rate | Typical range | Median |
|---|---|---|---|
| Medicare (national rate) | — | $240 to $240 | $240 |
| With insurance (commercial, average) | 8 | $226 to $6,298 | $1,291 |
| Without insurance (cash price) | 8 | $678 to $4,016 | $1,291 |
| Blue Cross and Blue Shield of Vermont | 7 | $185 to $5,238 | $736 |
| UnitedHealthcare | 7 | $152 to $7,233 | $264 |
| Cigna | 7 | $258 to $7,148 | $877 |
Rates are negotiated allowed amounts and cash prices from hospital price-transparency files (October 2026), shown at each hospital’s lowest-priced typical billing code for this procedure. Facility fees only. The typical range is the middle 80% of hospitals, not a quote for your visit.
How much does a prostate biopsy cost with Medicare in Vermont?
Medicare's national fee-schedule payment for prostate biopsy is about $240 to $240 (typically near $240). After the $257 Part B deductible, you generally pay 20% of the Medicare-approved amount, about $48 on a $240 payment, with no out-of-pocket cap unless you have supplemental coverage or a Medicare Advantage plan.
Doctor, anesthesia and pathology fees are billed separately. Medicare rates are national CMS amounts, adjusted slightly by local wage levels.
How much does a prostate biopsy cost with insurance in Vermont?
Across 8 Vermont hospitals, the negotiated rates commercial insurers pay for prostate biopsy average $226 to $6,298 per hospital, with a median near $1,291. That is the amount your plan and you pay the hospital together; you owe your deductible, then coinsurance, up to your out-of-pocket maximum.
Each hospital’s figure is the average of the commercial insurers it lists. Medicare, Medicare Advantage and Medicaid rates are excluded.
How much does a prostate biopsy cost without insurance in Vermont?
Cash (self-pay) prices for prostate biopsy at 8 Vermont hospitals range from $678 to $4,016, with a median of $1,291. Ask for the cash or self-pay price and for any financial-assistance discount before you book; both can be lower than the posted price.
Cash prices are the hospital’s published discounted rate for patients paying without insurance.
How much does a prostate biopsy cost with Blue Cross and Blue Shield of Vermont?
Blue Cross and Blue Shield of Vermont negotiated rates for prostate biopsy at 7 Vermont hospitals range from $185 to $5,238, with a median near $736. Your own cost depends on your plan’s deductible and coinsurance, and on whether the hospital is in your network.
Includes Blue Cross and Blue Shield and Anthem plans listed by each hospital.
How much does a prostate biopsy cost with UnitedHealthcare in Vermont?
UnitedHealthcare negotiated rates for prostate biopsy at 7 Vermont hospitals range from $152 to $7,233, with a median near $264. If a hospital is out of network for your UnitedHealthcare plan, you may owe more than the negotiated rate, so check the network first.
How much does a prostate biopsy cost with Cigna in Vermont?
Cigna negotiated rates for prostate biopsy at 7 Vermont hospitals range from $258 to $7,148, with a median near $877. If a hospital is out of network for your Cigna plan, you may owe more than the negotiated rate, so check the network first.
How where you go changes what you pay for prostate biopsy
The same prostate biopsy bundles different services depending on the setting - facility fee, surgeon fee, and anesthesia each arrive as separate bills. Estimated ranges below reflect the typical full bundled cost, including all expected charges.
- Facility fee $113–$4,535
- Professional fee $189–$504
Estimated from CMS fee schedules + commercial rate multipliers
- Facility fee $113–$4,535
- Professional fee $189–$504
Estimated from CMS fee schedules + commercial rate multipliers
The University of Vermont Health Network effectively dominates Vermont's hospital market, with limited competitive alternatives statewide. Vermont's all-payer ACO model and its history of near-single-payer reform have created a more price-regulated environment than most states. Prices here are relatively compressed compared to New England neighbors, but not dramatically below the regional average.
Received a bill? Check it for errors → Estimate YOUR cost before you go → Managing more than one bill? See the family tracker →
Why prices vary - and what it means for your coverage
Setting matters too: the median outpatient price is $999 versus $999 inpatient, so where a procedure happens often matters more than which hospital you pick.
What you pay out of pocket on top of this depends on your deductible, your plan's out-of-pocket maximum, and whether every provider involved is in-network - not just the facility.
| Your situation | Estimated out-of-pocket |
|---|---|
| Deductible not yet met | ~$999 |
| Deductible met - 20% coinsurance | ~$200 |
| Out-of-network provider | $2,198+ |
Frequently asked questions: prostate biopsy costs in Vermont
How much does a prostate biopsy cost in Vermont?
The typical insurer-negotiated rate is $348, with most facilities between $117 and $1,209 (based on 9 hospitals reporting negotiated rates). Posted cash prices at the middle 80% of Vermont hospitals run $678–$4,016; outlier facilities above and below that range are left out. What you pay depends on the facility, your insurance, and whether you have met your deductible.
Where is the cheapest place to get a prostate biopsy in Vermont?
Based on declared prices, the lowest posted price in our Vermont data is Gifford Medical Center in Randolph at about $548.
Why is a prostate biopsy so much cheaper at some Vermont hospitals?
Typical prices vary about 10.3× (25th to 70th percentile of negotiated rates) because each hospital sets its own list price, cash discount, and insurer-negotiated rates. In Vermont, the median cash (self-pay) price is $1,291 versus a median negotiated rate of $1,291 - about 1× higher. Asking for the cash price as well as your insurer's negotiated rate is often the single biggest lever on what you pay.
How much will I actually pay out of pocket for a prostate biopsy in Vermont?
Your out-of-pocket cost depends on your deductible, coinsurance, out-of-pocket maximum, and whether the facility is in-network - not just the sticker price. If you have not met your deductible, you will typically pay the negotiated rate in full until you do. Use the CostKits cost forecaster to estimate your specific out-of-pocket amount before you go.
Before you book
- Allowed amount vs negotiated rate: what your EOB is really saying
- How to read your medical bill
- Deductible vs out-of-pocket max
- Already have a bill? Check it for errors
- Understanding your UnitedHealthcare EOB
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CostKits compiles hospital price transparency data to help families make informed decisions. Track and manage your healthcare costs (free account).
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About the Author
John Caruso, FSA, MAAA
Healthcare actuary with 20+ years of experience in insurance pricing, medical billing systems, and healthcare cost analytics.
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