Diagnostic radiology · Vermont

Diagnostic radiology commercial reimbursement in Vermont

How Vermont diagnostic radiology rates compare with the national market.

Diagnostic radiology in Vermont

49 codes · 65 sampled providers
Index vs national
101
1% above
Rank among states
23 of 51
1 = highest
Codes above national
27 of 49
median code at 101%
Providers
65
sampled

What the data shows

1

Diagnostic radiology ranks 23rd of 51 states in Vermont with an index of 101 (100 = the specialty's national median), across 49 codes and 65 sampled providers.

2

Of the 49 diagnostic radiology codes with enough data in Vermont, 27 pay above the national median and 22 below; the typical code sits at 101% of the national median.

3

Largest premium over the national median: CPT 71275 (Ct angiography chest) at 122%; largest discount: CPT 70553 (Mri brain stem w/o & w/dye) at 87%.

4

Measured against Medicare, Vermont diagnostic radiology rates have a median of 153% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeVermontNationalGapProv.
71275
Ct angiography chest
$562$462+22%63
93000
Electrocardiogram complete
$30$25+21%61
99212
Office o/p est sf 10 min
$57$50+13%63
20610
Drain/inj joint/bursa w/o us
$93$83+12%63
99203
Office o/p new low 30 min
$134$121+12%63

Lowest vs national

CodeVermontNationalGapProv.
70553
Mri brain stem w/o & w/dye
$520$600-13%63
72158
Mri lumbar spine w/o & w/dye
$522$593-12%63
70450
Ct head/brain w/o dye
$175$194-10%63
77080
Dxa bone density axial
$60$66-10%63
70498
Ct angiography neck
$422$459-8%63

All diagnostic radiology codes in Vermont

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeVermontNationalGap% of MedicareProvidersTINsLevel
CPT 71275
Ct angiography chest
$562$462+22%200%63124
CPT 93000
Electrocardiogram complete
$30$25+21%197%6196
CPT 99212
Office o/p est sf 10 min
$57$50+13%96%63127
CPT 20610
Drain/inj joint/bursa w/o us
$93$83+12%135%63128
CPT 99203
Office o/p new low 30 min
$134$121+11%114%63127
CPT 99213
Office o/p est low 20 min
$96$88+9%100%63127
CPT 99214
Office o/p est mod 30 min
$136$128+6%100%63126
CPT 74174
Cta abd&plvs w/contrast
$634$601+6%168%63125
CPT 99215
Office o/p est hi 40 min
$189$182+4%98%63121
CPT 76536
Us exam of head and neck
$160$154+3%147%63126
CPT 77067
Scr mammo bi incl cad
$188$182+3%149%63123
CPT 99204
Office o/p new mod 45 min
$193$187+3%109%63126
CPT 77066
Dx mammo incl cad bi
$232$225+3%148%63128
CPT 71045
X-ray exam chest 1 view
$34$33+3%133%63124
CPT 77065
Dx mammo incl cad uni
$184$179+3%148%63123
CPT 74177
Ct abd & pelvis w/contrast
$461$448+3%153%63126
CPT 76641
Ultrasound breast complete
$149$145+2%148%63123
CPT 73502
X-ray exam hip uni 2-3 views
$63$61+2%129%63124
CPT 93880
Extracranial bilat study
$282$277+2%149%63124
CPT 37243
Vasc embolize/occlude organ
$869$858+1%180%60115
CPT 76700
Us exam abdom complete
$170$168+1%149%63126
CPT 76642
Ultrasound breast limited
$122$120+1%146%63124
CPT 72141
Mri neck spine w/o dye
$394$390+1%206%63125
CPT 71271
Ct thorax lung cancer scr c-
$210$208+1%154%63129
CPT 76705
Echo exam of abdomen
$127$126+1%147%63126
CPT 72148
Mri lumbar spine w/o dye
$394$392+0%205%63125
CPT 99205
Office o/p new hi 60 min
$244$244+0%103%63123
CPT 74178
Ct abd&plv wo cntr flwd cntr
$516$520-1%153%63124
CPT 76770
Us exam abdo back wall comp
$157$158-1%148%63125
CPT 72125
Ct neck spine w/o dye
$245$249-2%187%63124
CPT 71046
X-ray exam chest 2 views
$44$45-2%134%63124
CPT 70551
Mri brain stem w/o dye
$394$402-2%202%63124
CPT 71250
Ct thorax dx c-
$245$250-2%185%63126
CPT 72131
Ct lumbar spine w/o dye
$242$248-2%186%63123
CPT 74176
Ct abd & pelvis w/o contrast
$280$287-2%153%63126
CPT 93971
Extremity study
$167$172-3%144%63130
CPT 73721
Mri jnt of lwr extre w/o dye
$394$407-3%193%63125
CPT 73221
Mri joint upr extrem w/o dye
$394$407-3%192%63125
CPT 77049
Mri breast c-+ w/cad bi
$534$558-4%157%63124
CPT 71260
Ct thorax dx c+
$298$312-4%179%63124
CPT 93970
Extremity study
$258$270-5%140%63130
CPT 74183
Mri abd w/o cntr flwd cntr
$595$634-6%177%63125
CPT 72197
Mri pelvis w/o & w/dye
$594$634-6%178%63125
CPT 70496
Ct angiography head
$422$457-8%154%63125
CPT 70498
Ct angiography neck
$422$459-8%154%63125
CPT 77080
Dxa bone density axial
$60$66-10%152%63124
CPT 70450
Ct head/brain w/o dye
$175$194-10%164%63126
CPT 72158
Mri lumbar spine w/o & w/dye
$522$593-12%164%63124
CPT 70553
Mri brain stem w/o & w/dye
$520$600-13%164%63125

Frequently asked questions

How do Vermont diagnostic radiology rates compare with the rest of the country?

Vermont ranks 23rd of 51 states with an index of 101; 27 of 49 codes are above the national median.

Which diagnostic radiology code has the biggest premium in Vermont?

CPT 71275 (Ct angiography chest), at 122% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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