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Acute Care Hospital

Kent County Memorial Hospital

Also listed as: Kent Hospital

Warwick, Rhode Island · Kent County · Emergency services listed

Kent County Memorial Hospital is an acute care hospital at 455 Toll Gate Rd, Warwick, RI 02886. Phone: (401) 737-7010. It has an emergency department. Medicare overall rating: 3 of 5 stars (CMS, October 2026).

Data as of October 26, 2026. Source: CMS Hospital General Information and the hospital’s website (checked October 30, 2026).

Summary

Kent County Memorial Hospital is an acute care hospital in Warwick, Rhode Island. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 87 services, specialties and programs. Medicare lists 976 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

A general hospital for short-term care: emergencies, surgery, illness and injury. Most patients stay a few days. More about hospital types

Call(401) 737‑7010 Directions Website Medicare profile
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Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-10-30). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
3 of 5 stars3 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
976Doctors and clinicians
87Services listed

Quick answers

Does Kent County Memorial Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Kent County Memorial Hospital. In a medical emergency, call 911.
Where is Kent County Memorial Hospital?
455 Toll Gate Rd, Warwick, RI 02886, in Kent County, Rhode Island.
What is the phone number of Kent County Memorial Hospital?
(401) 737-7010, as listed by Medicare (CMS).
What is the Medicare star rating of Kent County Memorial Hospital?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Kent County Memorial Hospital for hospital-acquired conditions?
Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Kent County Memorial Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.4228; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[4][5][8][9][15][16][19]

Conditions treated[4][5][6][12][14]

Treatments[6][8][9][12][13][14][15][16][18]

  • Clot-dissolving medication for stroke
  • Stroke rehabilitation therapy
  • Angiography
  • Balloon angioplasty
  • Atherectomy
  • Vascular stenting
  • Thrombolytic therapy
  • Uterine fibroid embolization
  • TIPS procedure
  • Biliary drainage and stent placement
  • Inferior vena cava filter placement
  • PICC line placement
  • Port-a-cath placement
  • Dialysis catheter placement
  • Abscess drainage
  • Gastrointestinal bleeding embolization
  • Myelogram
  • Paracentesis

Procedures[4]

Programs and centers[4][5][6][10][12][14][15][16][17][19]

  • Stroke Program
  • Kent Hospital at Home
  • Kidney Stone Center
  • Lung Health Clinic
  • Inpatient Rehabilitation
  • Amputee Specialty Unit
  • Acute Care for Elders (ACE) Inpatient Unit
  • Cancer Program
  • Breast Health Center
  • Women's Care Center
  • Spaulding Joint Health Program
  • Infusion Center

Emergency care (hospital website)[5][11]

Emergency roomYes
Open 24/7Yes
Stroke designationJoint Commission certified Advanced Primary Stroke Program (2008)

Visiting and practical information

ParkingFree visitor parking; reserved handicapped parking at the Main Entrance and near Emergency Services[7]
Interpreters and languagesInterpreter services and communication devices upon request (inpatient rehab unit)[12]

Recognition[4][5][12][13][15][18]

  • Advanced Total Hip and Knee Replacement Certification
  • Accredited as a Geriatric Emergency Department (American College of Emergency Physicians)
  • Community Hospital Cancer Program with commendation (American College of Surgeons Commission on Cancer)
  • American College of Radiology Designated Lung Cancer Screening Center
  • CARF accreditation, stroke specialty (rehabilitation)
  • Joint Commission accreditation, Inpatient Rehabilitation Program

Doctors and clinicians (976)

976 doctors and other clinicians list Kent County Memorial Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (976)

And 952 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near Warwick

Hospitals in Kent County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Clinics and urgent care

Pharmacies

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Kent County Memorial Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Summary star rating (all survey topics) 3 of 5 stars
Overall rating of the hospital3 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well3 of 5 stars
Doctors communicated well4 of 5 stars
Patients got help quickly from staff3 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean3 of 5 stars
Restfulness of Environment2 of 5 stars
Care Coordination3 of 5 stars
Symptoms After Stay3 of 5 stars
Rated the hospital 9 or 10 out of 1063%National average: 72%
Would definitely recommend the hospital62%National average: 71%
Nurses “always” communicated well79%National average: 80%
Doctors “always” communicated well81%National average: 80%
“Always” got help as soon as they wanted60%National average: 64%
Staff “always” explained medicines before giving them60%National average: 62%
Were given information about recovery at home88%National average: 86%
Room and bathroom “always” clean68%National average: 73%
Completed surveys1,266Response rate: 26%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)0.808No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)1.128No different from the national benchmark
Surgical site infections after colon surgery0.325No different from the national benchmark
MRSA bloodstream infections0.811No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.526No different from the national benchmark
Not reported to MedicareSurgical site infections after abdominal hysterectomy

Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients11.6%
Deaths within 30 days: heart failure patients10.5%
Deaths within 30 days: pneumonia patients15.4%
Deaths within 30 days: COPD patients6.4%
Deaths within 30 days: stroke patients9.2%
Serious complications (patient safety indicator PSI-90)1.17No different from the national rate
Complications after hip or knee replacement4.4%
Not reported to MedicareDeaths within 30 days: coronary bypass surgery (CABG)

Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)16%
Readmitted within 30 days: heart attack14.3%
Readmitted within 30 days: heart failure22%
Readmitted within 30 days: pneumonia16%
Readmitted within 30 days: COPD18.8%
Readmitted within 30 days: hip or knee replacement6.1%
Not reported to MedicareReadmitted within 30 days: coronary bypass surgery

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)256 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)4%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)62%National average: 66%

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

Medicare payment programs

Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for Kent County Memorial Hospital, fiscal year 2026 (October 2025 to September 2026).

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

What this means: Medicare gives each hospital a Total HAC Score built from patient-safety complications and from infections caught in the hospital. The quarter of hospitals with the highest (worst) scores gets a reduction in its Medicare payments. A lower score is better.

CMS says: Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction.

Medicare payment reduction, fiscal year 2026YesCMS applies a 1-percent payment reduction to this hospital.
Total HAC Score0.4228Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

Source: Hospital-Acquired Condition (HAC) Reduction Program — CMS, released January 26, 2026; patient-safety data from July 2022 to June 2024 and infection data from January 2023 to December 2024.

Hospital Readmissions Reduction Program

What this means: For six conditions, Medicare compares how often this hospital’s patients had to go back into a hospital within 30 days with how often that happens at an average hospital with similar patients. The ratio is that comparison: 1 means as many readmissions as expected, above 1 means more than expected (CMS calls these “excess readmissions”), below 1 means fewer.

CMS says: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP).

Heart attack0.9997Fewer readmissions than expected
Heart failure1.0495More readmissions than expected
Pneumonia0.9232Fewer readmissions than expected
COPD (chronic lung disease)1.1151More readmissions than expected
Hip or knee replacement0.8833Fewer readmissions than expected
No result publishedCoronary bypass surgery (CABG) (not reported, or too few cases)

Source: Hospital Readmissions Reduction Program — CMS, released January 26, 2026; patients discharged July 2021 to June 2024.

Hospital Value-Based Purchasing Program

What this means: Medicare scores hospitals in four areas, each from 0 to 100, and combines them into a Total Performance Score from 0 to 100. A higher score means better results on these measures. Medicare uses the score to adjust what it pays the hospital.

CMS says: This program adjusts payments to hospitals under the Inpatient Prospective Payment System (IPPS) based on the quality of care they deliver.

Total Performance Score15.33 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)20.00 out of 100
Person and community engagement (patient survey)33.00 out of 100
Safety (infections and sepsis care)8.33 out of 100
Efficiency and cost reduction (Medicare spending)0.00 out of 100

Source: Hospital Value-Based Purchasing (HVBP) - Total Performance Score — CMS, released January 26, 2026, fiscal year 2026. Program description: The Hospital Value-Based Purchasing (VBP) Program — CMS, page last modified September 10, 2024.

Medicare spending per patient (MSPB)

What this means: This compares what Medicare spent on a hospital stay, counting the 3 days before it and the 30 days after, with the national median hospital, after adjusting for the patient’s age and health and for local prices. A ratio of 1.00 is the national median hospital; below 1.00 means Medicare spent less, above 1.00 means more. It measures the cost to Medicare, not the quality of care.

CMS says: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally.

Medicare spending per patient, ratio1.03Above the national median hospital (1.00): Medicare spent more

Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Rhode IslandBest hospitals in Rhode Island

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 64 common services exactly as Kent County Memorial Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean
Hospital charge
The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price
The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates
The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees
A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

$ 18 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Show the prices of 64 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Office Outpatient New 30 Minutes $366 $128.10 $28.62 – $14,315.18
New patient office visit (about 30–44 minutes): 10 of 14 insurance plan rates
  • Blue Cross & Blue Shield of Rhode Island — HMO: $95.19
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $83.46
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $105.77
  • Blue Cross & Blue Shield of Rhode Island — PPO: $105.77
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $156.52
  • Tufts Health Public Plans — Managed Medicaid MA: $28.62
  • Tufts Health Public Plans — Managed Medicaid RI: $30.17
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: 93.3% (a percentage in the contract, not a dollar amount)
  • AETNA HEALTH MANAGEMENT, LLC — RI Preferred Commercial: 51% (a percentage in the contract, not a dollar amount)
  • Connecticare, Inc — COMMERCIAL: 50.35% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: HC Office Outpatient New 30 Minutes|PN - NON-EXCEPTED OFF-CAMPUS SVC $366 $128.10 $28.62 – $14,315.18
New patient office visit (about 30–44 minutes): 10 of 13 insurance plan rates
  • Blue Cross & Blue Shield of Rhode Island — HMO: $95.19
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $83.46
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $105.77
  • Blue Cross & Blue Shield of Rhode Island — PPO: $105.77
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $156.52
  • Tufts Health Public Plans — Managed Medicaid MA: $28.62
  • Tufts Health Public Plans — Managed Medicaid RI: $30.17
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: 93.3% (a percentage in the contract, not a dollar amount)
  • AETNA HEALTH MANAGEMENT, LLC — RI Preferred Commercial: 51% (a percentage in the contract, not a dollar amount)
  • Connecticut General Life Insurance Company — Evernorth: 50% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Office Outpatient New 45 Minutes $444 $155.40 $28.62 – $14,315.18
New patient office visit (about 45–59 minutes): 10 of 14 insurance plan rates
  • Blue Cross & Blue Shield of Rhode Island — HMO: $155.03
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $135.92
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $172.26
  • Blue Cross & Blue Shield of Rhode Island — PPO: $172.26
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $238.40
  • Tufts Health Public Plans — Managed Medicaid MA: $28.62
  • Tufts Health Public Plans — Managed Medicaid RI: $30.17
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: 93.3% (a percentage in the contract, not a dollar amount)
  • AETNA HEALTH MANAGEMENT, LLC — RI Preferred Commercial: 51% (a percentage in the contract, not a dollar amount)
  • Connecticare, Inc — COMMERCIAL: 50.35% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: HC Office Outpatient New 45 Minutes|PN - NON-EXCEPTED OFF-CAMPUS SVC $444 $155.40 $28.62 – $14,315.18
New patient office visit (about 45–59 minutes): 10 of 13 insurance plan rates
  • Blue Cross & Blue Shield of Rhode Island — HMO: $155.03
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $135.92
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $172.26
  • Blue Cross & Blue Shield of Rhode Island — PPO: $172.26
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $238.40
  • Tufts Health Public Plans — Managed Medicaid MA: $28.62
  • Tufts Health Public Plans — Managed Medicaid RI: $30.17
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: 93.3% (a percentage in the contract, not a dollar amount)
  • AETNA HEALTH MANAGEMENT, LLC — RI Preferred Commercial: 51% (a percentage in the contract, not a dollar amount)
  • Connecticut General Life Insurance Company — Evernorth: 50% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Office Outpatient New 60 Minutes $501 $175.35 $28.62 – $14,315.18
New patient office visit (about 60–74 minutes): 10 of 14 insurance plan rates
  • Blue Cross & Blue Shield of Rhode Island — HMO: $210.87
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $184.88
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $234.30
  • Blue Cross & Blue Shield of Rhode Island — PPO: $234.30
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $412.44
  • Tufts Health Public Plans — Managed Medicaid MA: $28.62
  • Tufts Health Public Plans — Managed Medicaid RI: $30.17
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: 93.3% (a percentage in the contract, not a dollar amount)
  • AETNA HEALTH MANAGEMENT, LLC — RI Preferred Commercial: 51% (a percentage in the contract, not a dollar amount)
  • Connecticare, Inc — COMMERCIAL: 50.35% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: HC Office Outpatient New 60 Minutes|PN - NON-EXCEPTED OFF-CAMPUS SVC $501 $175.35 $28.62 – $14,315.18
New patient office visit (about 60–74 minutes): 10 of 13 insurance plan rates
  • Blue Cross & Blue Shield of Rhode Island — HMO: $210.87
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $184.88
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $234.30
  • Blue Cross & Blue Shield of Rhode Island — PPO: $234.30
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $412.44
  • Tufts Health Public Plans — Managed Medicaid MA: $28.62
  • Tufts Health Public Plans — Managed Medicaid RI: $30.17
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: 93.3% (a percentage in the contract, not a dollar amount)
  • AETNA HEALTH MANAGEMENT, LLC — RI Preferred Commercial: 51% (a percentage in the contract, not a dollar amount)
  • Connecticut General Life Insurance Company — Evernorth: 50% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Office Outpatient Visit 15 Minutes $261 $91.35 $28.62 – $6,036.48
Established patient office visit (about 20–29 minutes): 10 of 15 insurance plan rates
  • Blue Cross & Blue Shield of Rhode Island — HMO: $71.87
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $67.22
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $79.86
  • Blue Cross & Blue Shield of Rhode Island — PPO: $79.86
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $238.85
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $70.67
  • Tufts Health Public Plans — Managed Medicaid MA: $28.62
  • Tufts Health Public Plans — Managed Medicaid RI: $30.17
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: 93.3% (a percentage in the contract, not a dollar amount)
  • AETNA HEALTH MANAGEMENT, LLC — RI Preferred Commercial: 51% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: HC Office Outpatient Visit 15 Minutes|PN - NON-EXCEPTED OFF-CAMPUS SVC $261 $91.35 $28.62 – $6,036.48
Established patient office visit (about 20–29 minutes): 10 of 14 insurance plan rates
  • Blue Cross & Blue Shield of Rhode Island — HMO: $71.87
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $67.22
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $79.86
  • Blue Cross & Blue Shield of Rhode Island — PPO: $79.86
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $238.85
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $70.67
  • Tufts Health Public Plans — Managed Medicaid MA: $28.62
  • Tufts Health Public Plans — Managed Medicaid RI: $30.17
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: 93.3% (a percentage in the contract, not a dollar amount)
  • AETNA HEALTH MANAGEMENT, LLC — RI Preferred Commercial: 51% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Office Outpatient Visit 25 Minutes $340 $119 $28.62 – $6,207.14
Established patient office visit (about 30–39 minutes): 10 of 15 insurance plan rates
  • Blue Cross & Blue Shield of Rhode Island — HMO: $106.03
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $99.15
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $117.81
  • Blue Cross & Blue Shield of Rhode Island — PPO: $117.81
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $185.91
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $104.41
  • Tufts Health Public Plans — Managed Medicaid MA: $28.62
  • Tufts Health Public Plans — Managed Medicaid RI: $30.17
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: 93.3% (a percentage in the contract, not a dollar amount)
  • AETNA HEALTH MANAGEMENT, LLC — RI Preferred Commercial: 51% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: HC Office Outpatient Visit 25 Minutes|PN - NON-EXCEPTED OFF-CAMPUS SVC $340 $119 $28.62 – $6,207.14
Established patient office visit (about 30–39 minutes): 10 of 14 insurance plan rates
  • Blue Cross & Blue Shield of Rhode Island — HMO: $106.03
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $99.15
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $117.81
  • Blue Cross & Blue Shield of Rhode Island — PPO: $117.81
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $185.91
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $104.41
  • Tufts Health Public Plans — Managed Medicaid MA: $28.62
  • Tufts Health Public Plans — Managed Medicaid RI: $30.17
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: 93.3% (a percentage in the contract, not a dollar amount)
  • AETNA HEALTH MANAGEMENT, LLC — RI Preferred Commercial: 51% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER Visit Level 3 $1,478 $517.30 $147.11 – $1,378.97
Emergency room visit (moderate): 10 of 20 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $314.27
  • Blue Cross & Blue Shield of Rhode Island — HMO: $576.46
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $511.57
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $640.51
  • Blue Cross & Blue Shield of Rhode Island — PPO: $640.51
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $448.95
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $491.71
  • Neighborhood Health Plan of Rhode Island — Integrity: $305.41
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $299.30
  • Tufts Health Public Plans — Managed Medicaid MA: $180.24
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER Visit Level 4 $2,502 $875.70 $147.11 – $2,587
Emergency room visit (moderately high): 10 of 20 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $480.39
  • Blue Cross & Blue Shield of Rhode Island — HMO: $922.24
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $818.50
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $1,024.71
  • Blue Cross & Blue Shield of Rhode Island — PPO: $1,024.71
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $686.27
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $751.63
  • Neighborhood Health Plan of Rhode Island — Integrity: $466.85
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $457.51
  • Tufts Health Public Plans — Managed Medicaid MA: $288.38
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER Visit Level 5 $3,029 $1,060.15 $147.11 – $3,134
Emergency room visit (high): 10 of 20 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $685.62
  • Blue Cross & Blue Shield of Rhode Island — HMO: $1,386.03
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $1,230.09
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $1,540.03
  • Blue Cross & Blue Shield of Rhode Island — PPO: $1,540.03
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $979.46
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $1,072.74
  • Neighborhood Health Plan of Rhode Island — Integrity: $666.30
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $652.97
  • Tufts Health Public Plans — Managed Medicaid MA: $433.39

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Basic Metabolic Panel Calcium Total - Bundled Charge $99 $34.65 $3.89 – $87.12
Basic metabolic panel (blood test): 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $25.34
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $8.71
  • Blue Cross & Blue Shield of Rhode Island — HMO: $10.36
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $5.18
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $11.51
  • Blue Cross & Blue Shield of Rhode Island — PPO: $11.51
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $12.44
  • Connecticare, Inc — COMMERCIAL: $17.29
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $8.90
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $13.62
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Metabolic Panel,Comprehensive - Bundled Charge $124 $43.40 $4.86 – $142.63
Comprehensive metabolic panel (blood test): 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $31.66
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $10.87
  • Blue Cross & Blue Shield of Rhode Island — HMO: $12.93
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $6.47
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $14.37
  • Blue Cross & Blue Shield of Rhode Island — PPO: $14.37
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $15.52
  • Connecticare, Inc — COMMERCIAL: $21.24
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $11.11
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $17
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Lipid Panel - Bundled Charge $107 $37.45 $6.16 – $142.63
Cholesterol panel (lipid panel): 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $40.13
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $13.78
  • Blue Cross & Blue Shield of Rhode Island — HMO: $16.40
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $8.20
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $18.22
  • Blue Cross & Blue Shield of Rhode Island — PPO: $18.22
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $19.68
  • Connecticare, Inc — COMMERCIAL: $32.60
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $14.08
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $21.56
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Renal Function Panel - Bundled Charge $98 $34.30 $3.99 – $86.24
Kidney function panel: 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $26.03
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $8.93
  • Blue Cross & Blue Shield of Rhode Island — HMO: $10.64
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $5.32
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $11.82
  • Blue Cross & Blue Shield of Rhode Island — PPO: $11.82
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $12.76
  • Connecticare, Inc — COMMERCIAL: $17.78
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $9.12
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $13.97
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Hepatic Function Panel - Bundled Charge $96 $33.60 $3.76 – $177.38
Liver function panel: 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $24.49
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $8.41
  • Blue Cross & Blue Shield of Rhode Island — HMO: $10
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $5
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $11.11
  • Blue Cross & Blue Shield of Rhode Island — PPO: $11.11
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $12.01
  • Connecticare, Inc — COMMERCIAL: $16.79
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $8.59
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $13.15
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: HC Hepatic Function Panel - Bundled Charge|PN - NON-EXCEPTED OFF-CAMPUS SVC $96 $33.60 $3.76 – $177.38
Liver function panel: 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $24.49
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $8.41
  • Blue Cross & Blue Shield of Rhode Island — HMO: $10
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $5
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $11.11
  • Blue Cross & Blue Shield of Rhode Island — PPO: $11.11
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $12.01
  • Connecticare, Inc — COMMERCIAL: $16.79
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $8.59
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $13.15
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis, Auto, W/Scope - Urinalysis Microscopic $31 $10.85 $1.46 – $31.16
Urine test (automated, with microscope): 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $9.50
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $3.26
  • Blue Cross & Blue Shield of Rhode Island — HMO: $3.88
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $1.94
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $4.31
  • Blue Cross & Blue Shield of Rhode Island — PPO: $4.31
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $4.66
  • Connecticare, Inc — COMMERCIAL: $6.42
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $3.33
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $5.10
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pbb Urinalysis Nonauto W/O Scope $17 $5.95 $1.57 – $46.08
Urine test (manual, without microscope): 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $7.66
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $3.58
  • Blue Cross & Blue Shield of Rhode Island — HMO: $3.13
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $1.57
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $3.48
  • Blue Cross & Blue Shield of Rhode Island — PPO: $3.48
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $5.12
  • Connecticare, Inc — COMMERCIAL: $4.94
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $2.68
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $5.60
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis, Auto, W/O Scope - Urinalysis Chem Only $36 $12.60 $1.04 – $31.68
Urine test (automated, without microscope): 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $5.72
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $2.32
  • Blue Cross & Blue Shield of Rhode Island — HMO: $2.34
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $1.17
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $2.60
  • Blue Cross & Blue Shield of Rhode Island — PPO: $2.60
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $3.31
  • Connecticare, Inc — COMMERCIAL: $4.45
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $2.36
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $3.62
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Prostate Specific Antigen,Total - Psa $141 $49.35 $6.80 – $124.14
PSA (prostate specific antigen) blood test: 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $54.93
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $18.92
  • Blue Cross & Blue Shield of Rhode Island — HMO: $22.46
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $11.23
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $24.95
  • Blue Cross & Blue Shield of Rhode Island — PPO: $24.95
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $27.03
  • Connecticare, Inc — COMMERCIAL: $37.05
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $19.33
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $29.61
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Assay Thyroid Stim Hormone - Thyroid Stimulating Hormone $111 $38.85 $5.85 – $97.68
Thyroid stimulating hormone (TSH) test: 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $50.36
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $17.29
  • Blue Cross & Blue Shield of Rhode Island — HMO: $20.58
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $10.29
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $22.87
  • Blue Cross & Blue Shield of Rhode Island — PPO: $22.87
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $24.70
  • Connecticare, Inc — COMMERCIAL: $34.08
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $17.65
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $27.05
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN|QW In the file: HC Assay Thyroid Stim Hormone - Thyroid Stimulating Hormone|PN - NON-EXCEPTED OFF-CAMPUS SVC|CLIA WAIVED TEST $111 $38.85 $5.85 – $97.68
Thyroid stimulating hormone (TSH) test: 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $50.36
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $17.29
  • Blue Cross & Blue Shield of Rhode Island — HMO: $20.58
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $10.29
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $22.87
  • Blue Cross & Blue Shield of Rhode Island — PPO: $22.87
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $24.70
  • Connecticare, Inc — COMMERCIAL: $34.08
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $17.65
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $27.05
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: HC Assay Thyroid Stim Hormone - Thyroid Stimulating Hormone|PN - NON-EXCEPTED OFF-CAMPUS SVC $111 $38.85 $5.85 – $97.68
Thyroid stimulating hormone (TSH) test: 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $50.36
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $17.29
  • Blue Cross & Blue Shield of Rhode Island — HMO: $20.58
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $10.29
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $22.87
  • Blue Cross & Blue Shield of Rhode Island — PPO: $22.87
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $24.70
  • Connecticare, Inc — COMMERCIAL: $34.08
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $17.65
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $27.05
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Complete Cbc & Auto Diff Wbc - Additional Charge $78 $27.30 $3.57 – $68.64
Complete blood count (CBC) with differential: 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $23.30
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $8
  • Blue Cross & Blue Shield of Rhode Island — HMO: $9.52
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $4.76
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $10.58
  • Blue Cross & Blue Shield of Rhode Island — PPO: $10.58
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $11.42
  • Connecticare, Inc — COMMERCIAL: $15.81
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $8.17
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $12.51
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Complete Cbc - Cbc $46 $16.10 $2.98 – $40.48
Complete blood count (CBC), automated: 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $19.38
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $6.66
  • Blue Cross & Blue Shield of Rhode Island — HMO: $7.93
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $3.96
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $8.81
  • Blue Cross & Blue Shield of Rhode Island — PPO: $8.81
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $9.51
  • Connecticare, Inc — COMMERCIAL: $13.34
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $6.80
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $10.42
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Prothrombin Time - Protime-Inr, Fingerstick $55 $19.25 $1.97 – $52.84
Blood clotting time test (prothrombin time, PT): 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $11.79
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $4.41
  • Blue Cross & Blue Shield of Rhode Island — HMO: $4.82
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $2.41
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $5.35
  • Blue Cross & Blue Shield of Rhode Island — PPO: $5.35
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $6.31
  • Connecticare, Inc — COMMERCIAL: $7.90
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $4.13
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $6.91
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Thromboplas Time Partial - Ptt Crrt System $62 $21.70 $2.76 – $62.35
Blood clotting test (partial thromboplastin time, PTT): 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — COMMERCIAL: $18
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $6.18
  • Blue Cross & Blue Shield of Rhode Island — HMO: $7.35
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $3.68
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $8.17
  • Blue Cross & Blue Shield of Rhode Island — PPO: $8.17
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $8.83
  • Connecticare, Inc — COMMERCIAL: $12.35
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $6.30
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $9.68

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Scan,Head/Brain,W/O Contrast Matl - CT Head WO Contrast $1,409 $493.15 $59.89 – $1,314.60
CT scan of the head or brain, without contrast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $120.36
  • Blue Cross & Blue Shield of Rhode Island — HMO: $138.97
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $89.81
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $154.41
  • Blue Cross & Blue Shield of Rhode Island — PPO: $154.41
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $171.95
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $94
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $188.32
  • Neighborhood Health Plan of Rhode Island — Integrity: $116.97
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $647.91
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC CT Scan,Head/Brain,W/O Contrast Matl - CT Head WO Contrast|TECHNICAL COMPONENT $1,409 $493.15 $59.89 – $1,314.60
CT scan of the head or brain, without contrast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $120.36
  • Blue Cross & Blue Shield of Rhode Island — HMO: $138.97
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $89.81
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $154.41
  • Blue Cross & Blue Shield of Rhode Island — PPO: $154.41
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $171.95
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $94
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $188.32
  • Neighborhood Health Plan of Rhode Island — Integrity: $116.97
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $647.91
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI Brain Combo - MRI Brain W WO Contrast $4,440 $1,554 $11.16 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,142.52
MRI of the brain, before and after contrast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $401.64
  • Blue Cross & Blue Shield of Rhode Island — HMO: $502.38
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $307.14
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $558.20
  • Blue Cross & Blue Shield of Rhode Island — PPO: $558.20
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $573.77
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $221.84
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $628.42
  • Neighborhood Health Plan of Rhode Island — Integrity: $390.32
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $1,554.19
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC MRI Brain Combo - MRI Brain W WO Contrast|TECHNICAL COMPONENT $4,440 $1,554 $11.16 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,142.52
MRI of the brain, before and after contrast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $401.64
  • Blue Cross & Blue Shield of Rhode Island — HMO: $502.38
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $307.14
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $558.20
  • Blue Cross & Blue Shield of Rhode Island — PPO: $558.20
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $573.77
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $221.84
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $628.42
  • Neighborhood Health Plan of Rhode Island — Integrity: $390.32
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $1,554.19
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Radiologic Exam Chest 2 Views - Xr Chest 2 Views $278 $97.30 $17.15 – $259.37
Chest X-ray, 2 views: 10 of 24 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $100.19
  • Blue Cross & Blue Shield of Rhode Island — HMO: $127.38
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $82.53
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $141.53
  • Blue Cross & Blue Shield of Rhode Island — PPO: $141.53
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $143.13
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $156.77
  • Neighborhood Health Plan of Rhode Island — Integrity: $97.37
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $42.93
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $95.42
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC Radiologic Exam Chest 2 Views - Xr Chest 2 Views|TECHNICAL COMPONENT $278 $97.30 $17.15 – $259.37
Chest X-ray, 2 views: 10 of 24 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $100.19
  • Blue Cross & Blue Shield of Rhode Island — HMO: $127.38
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $82.53
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $141.53
  • Blue Cross & Blue Shield of Rhode Island — PPO: $141.53
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $143.13
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $156.77
  • Neighborhood Health Plan of Rhode Island — Integrity: $97.37
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $42.93
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $95.42
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN|TC In the file: HC Radiologic Exam Chest 2 Views - Xr Chest 2 Views|PN - NON-EXCEPTED OFF-CAMPUS SVC|TECHNICAL COMPONENT $278 $97.30 $17.15 – $259.37
Chest X-ray, 2 views: 10 of 24 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $100.19
  • Blue Cross & Blue Shield of Rhode Island — HMO: $127.38
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $82.53
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $141.53
  • Blue Cross & Blue Shield of Rhode Island — PPO: $141.53
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $143.13
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $156.77
  • Neighborhood Health Plan of Rhode Island — Integrity: $97.37
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $42.93
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $95.42
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC X-Ray Lumbar Spine 4 Vw - Xr Lumbar Spine Complete 4+ Views $505 $176.75 $26.75 – $2,171.21
X-ray of the lower spine, at least 4 views: 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $120.36
  • Blue Cross & Blue Shield of Rhode Island — HMO: $145.26
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $94.12
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $161.40
  • Blue Cross & Blue Shield of Rhode Island — PPO: $161.40
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $171.95
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $26.75
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $188.32
  • Neighborhood Health Plan of Rhode Island — Integrity: $116.97
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $111.38
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC X-Ray Lumbar Spine 4 Vw - Xr Lumbar Spine Complete 4+ Views|TECHNICAL COMPONENT $505 $176.75 $26.75 – $2,171.21
X-ray of the lower spine, at least 4 views: 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $120.36
  • Blue Cross & Blue Shield of Rhode Island — HMO: $145.26
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $94.12
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $161.40
  • Blue Cross & Blue Shield of Rhode Island — PPO: $161.40
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $171.95
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $26.75
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $188.32
  • Neighborhood Health Plan of Rhode Island — Integrity: $116.97
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $111.38
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI, Lumbar Spine - MRI Lumbar Spine WO Contrast $1,930 $675.50 $185.92 – $1,800.69
MRI of the lower back (lumbar spine), without contrast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $274.69
  • Blue Cross & Blue Shield of Rhode Island — HMO: $339.75
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $185.92
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $377.50
  • Blue Cross & Blue Shield of Rhode Island — PPO: $377.50
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $392.42
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $221.84
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $429.79
  • Neighborhood Health Plan of Rhode Island — Integrity: $266.95
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $1,234.06
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC MRI, Lumbar Spine - MRI Lumbar Spine WO Contrast|TECHNICAL COMPONENT $1,930 $675.50 $185.92 – $1,800.69
MRI of the lower back (lumbar spine), without contrast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $274.69
  • Blue Cross & Blue Shield of Rhode Island — HMO: $339.75
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $185.92
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $377.50
  • Blue Cross & Blue Shield of Rhode Island — PPO: $377.50
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $392.42
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $221.84
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $429.79
  • Neighborhood Health Plan of Rhode Island — Integrity: $266.95
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $1,234.06
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Scan of Pelvis Contrast - CT Pelvis W Contrast $2,114 $739.90 $94 – $1,972.36
CT scan of the pelvis, with contrast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $201.93
  • Blue Cross & Blue Shield of Rhode Island — HMO: $231.95
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $195.33
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $257.72
  • Blue Cross & Blue Shield of Rhode Island — PPO: $257.72
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $288.47
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $94
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $315.95
  • Neighborhood Health Plan of Rhode Island — Integrity: $196.24
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $716.25
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI Jnt of Lwr Extre W/O Dye - MRI WO Cont $1,620 $567 $205.15 – $3,407.63
MRI of a leg joint (such as the knee), without contrast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $274.69
  • Blue Cross & Blue Shield of Rhode Island — HMO: $236.02
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $205.15
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $262.24
  • Blue Cross & Blue Shield of Rhode Island — PPO: $262.24
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $392.42
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $221.84
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $429.79
  • Neighborhood Health Plan of Rhode Island — Integrity: $266.95
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $1,234.06
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI Jnt of Lwr Extre W/O Dye - MRI Ankle WO Cont $1,620 $567 $205.15 – $3,407.63
MRI of a leg joint (such as the knee), without contrast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $274.69
  • Blue Cross & Blue Shield of Rhode Island — HMO: $236.02
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $205.15
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $262.24
  • Blue Cross & Blue Shield of Rhode Island — PPO: $262.24
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $392.42
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $221.84
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $429.79
  • Neighborhood Health Plan of Rhode Island — Integrity: $266.95
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $1,234.06
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI Jnt of Lwr Extre W/O Dye - MR Lower Ext Joint WO IV Cont $1,620 $567 $205.15 – $3,407.63
MRI of a leg joint (such as the knee), without contrast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $274.69
  • Blue Cross & Blue Shield of Rhode Island — HMO: $236.02
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $205.15
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $262.24
  • Blue Cross & Blue Shield of Rhode Island — PPO: $262.24
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $392.42
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $221.84
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $429.79
  • Neighborhood Health Plan of Rhode Island — Integrity: $266.95
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $1,234.06
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Abd & Pelv W/Contrast - CT Abdomen Pelvis W Contrast $4,858 $1,700.30 $94 – $4,532.51
CT scan of the abdomen and pelvis, with contrast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $401.64
  • Blue Cross & Blue Shield of Rhode Island — HMO: $275.66
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $256.93
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $306.29
  • Blue Cross & Blue Shield of Rhode Island — PPO: $306.29
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $573.77
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $94
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $628.42
  • Neighborhood Health Plan of Rhode Island — Integrity: $390.32
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $504.47
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC CT Abd & Pelv W/Contrast - CT Abdomen Pelvis W Contrast|TECHNICAL COMPONENT $4,858 $1,700.30 $94 – $4,532.51
CT scan of the abdomen and pelvis, with contrast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $401.64
  • Blue Cross & Blue Shield of Rhode Island — HMO: $275.66
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $256.93
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $306.29
  • Blue Cross & Blue Shield of Rhode Island — PPO: $306.29
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $573.77
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $94
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $628.42
  • Neighborhood Health Plan of Rhode Island — Integrity: $390.32
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $504.47
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US, Abdom,B-Scan &/or Real Time,Complete - US Abdomen Complete $794 $277.90 $16.66 – $740.80
Ultrasound of the abdomen, complete: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $120.36
  • Blue Cross & Blue Shield of Rhode Island — HMO: $203.65
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $131.96
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $226.28
  • Blue Cross & Blue Shield of Rhode Island — PPO: $226.28
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $171.95
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $16.66
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $188.32
  • Neighborhood Health Plan of Rhode Island — Integrity: $116.97
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $355.13
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC US, Abdom,B-Scan &/or Real Time,Complete - US Abdomen Complete|TECHNICAL COMPONENT $794 $277.90 $16.66 – $740.80
Ultrasound of the abdomen, complete: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $120.36
  • Blue Cross & Blue Shield of Rhode Island — HMO: $203.65
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $131.96
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $226.28
  • Blue Cross & Blue Shield of Rhode Island — PPO: $226.28
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $171.95
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $16.66
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $188.32
  • Neighborhood Health Plan of Rhode Island — Integrity: $116.97
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $355.13
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OB US >/= 14 Wks Sngl Fetus - US OB 14+ Weeks Single or First Gest $794 $277.90 $34.59 – $740.80
Pregnancy ultrasound (after the first trimester): 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $120.36
  • Blue Cross & Blue Shield of Rhode Island — HMO: $203.65
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $131.96
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $226.28
  • Blue Cross & Blue Shield of Rhode Island — PPO: $226.28
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $171.95
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $34.59
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $188.32
  • Neighborhood Health Plan of Rhode Island — Integrity: $116.97
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $377.11
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Echography,Transvaginal $675 $236.25 $34.59 – $629.78
Transvaginal ultrasound: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $120.36
  • Blue Cross & Blue Shield of Rhode Island — HMO: $203.65
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $131.96
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $226.28
  • Blue Cross & Blue Shield of Rhode Island — PPO: $226.28
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $171.95
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $34.59
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $188.32
  • Neighborhood Health Plan of Rhode Island — Integrity: $116.97
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $312.39
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC Echography,Transvaginal|TECHNICAL COMPONENT $675 $236.25 $34.59 – $629.78
Transvaginal ultrasound: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $120.36
  • Blue Cross & Blue Shield of Rhode Island — HMO: $203.65
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $131.96
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $226.28
  • Blue Cross & Blue Shield of Rhode Island — PPO: $226.28
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $171.95
  • HARVARD PILGRIM HEALTHCARE, INC. — COMMERCIAL: $34.59
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $188.32
  • Neighborhood Health Plan of Rhode Island — Integrity: $116.97
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $312.39
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Dx Mammo Incl Cad Uni - Mammo Additional Views $640 $224 $86.50 – $2,815.04
Diagnostic mammogram, one breast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $90.83
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $129.76
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $142.11
  • Neighborhood Health Plan of Rhode Island — Integrity: $88.27
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $191.71
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $86.50
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $92.65
  • Tufts Health Public Plans — Managed Medicaid RI: $152.02
  • United Healthcare Insurance Company — Commercial: $349.25
  • United Healthcare Insurance Company — Managed Medicaid: $199.14
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC Dx Mammo Incl Cad Uni - Mammo Additional Views|TECHNICAL COMPONENT $640 $224 $86.50 – $2,815.04
Diagnostic mammogram, one breast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $90.83
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $129.76
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $142.11
  • Neighborhood Health Plan of Rhode Island — Integrity: $88.27
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $191.71
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $86.50
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $92.65
  • Tufts Health Public Plans — Managed Medicaid RI: $152.02
  • United Healthcare Insurance Company — Commercial: $349.25
  • United Healthcare Insurance Company — Managed Medicaid: $199.14
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN|TC In the file: HC Dx Mammo Incl Cad Uni - Mammo Additional Views|PN - NON-EXCEPTED OFF-CAMPUS SVC|TECHNICAL COMPONENT $640 $224 $86.50 – $2,815.04
Diagnostic mammogram, one breast: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $90.83
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $129.76
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $142.11
  • Neighborhood Health Plan of Rhode Island — Integrity: $88.27
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $191.71
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $86.50
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $92.65
  • Tufts Health Public Plans — Managed Medicaid RI: $152.02
  • United Healthcare Insurance Company — Commercial: $349.25
  • United Healthcare Insurance Company — Managed Medicaid: $199.14
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Dx Mammo Incl Cad Bi - Mg Breast Bilateral Post Biopsy Clip $695 $243.25 $110.21 – $3,529.16
Diagnostic mammogram, both breasts: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $115.72
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $165.32
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $181.06
  • Neighborhood Health Plan of Rhode Island — Integrity: $112.46
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $243.30
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $110.21
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $118.13
  • Tufts Health Public Plans — Managed Medicaid RI: $194.17
  • United Healthcare Insurance Company — Commercial: $446.74
  • United Healthcare Insurance Company — Managed Medicaid: $254.73
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC Dx Mammo Incl Cad Bi - Mg Breast Bilateral Post Biopsy Clip|TECHNICAL COMPONENT $695 $243.25 $110.21 – $3,529.16
Diagnostic mammogram, both breasts: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $115.72
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $165.32
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $181.06
  • Neighborhood Health Plan of Rhode Island — Integrity: $112.46
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $243.30
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $110.21
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $118.13
  • Tufts Health Public Plans — Managed Medicaid RI: $194.17
  • United Healthcare Insurance Company — Commercial: $446.74
  • United Healthcare Insurance Company — Managed Medicaid: $254.73
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Scr Mammo Bi Incl Cad - Mammo Breast Screening $524 $183.40 $91.17 – $488.89
Screening mammogram, both breasts: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $95.73
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $136.75
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $149.78
  • Neighborhood Health Plan of Rhode Island — Integrity: $93.03
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $196.47
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $91.17
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $97.96
  • Tufts Health Public Plans — Managed Medicaid RI: $160.56
  • United Healthcare Insurance Company — Commercial: $369
  • United Healthcare Insurance Company — Managed Medicaid: $210.40
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC Scr Mammo Bi Incl Cad - Mammo Breast Screening|TECHNICAL COMPONENT $524 $183.40 $91.17 – $488.89
Screening mammogram, both breasts: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $95.73
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $136.75
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $149.78
  • Neighborhood Health Plan of Rhode Island — Integrity: $93.03
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $196.47
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $91.17
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $97.96
  • Tufts Health Public Plans — Managed Medicaid RI: $160.56
  • United Healthcare Insurance Company — Commercial: $369
  • United Healthcare Insurance Company — Managed Medicaid: $210.40
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN|TC In the file: HC Scr Mammo Bi Incl Cad - Mammo Breast Screening|PN - NON-EXCEPTED OFF-CAMPUS SVC|TECHNICAL COMPONENT $524 $183.40 $91.17 – $488.89
Screening mammogram, both breasts: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $95.73
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $136.75
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $149.78
  • Neighborhood Health Plan of Rhode Island — Integrity: $93.03
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $196.47
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $91.17
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $97.96
  • Tufts Health Public Plans — Managed Medicaid RI: $160.56
  • United Healthcare Insurance Company — Commercial: $369
  • United Healthcare Insurance Company — Managed Medicaid: $210.40

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cath Left Heart Cath Inject Vetriculography, Image Supervise/Interp $5,556 $1,944.60 $143.23 – $7,498
Left heart catheterization (diagnostic): 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $3,732.34
  • Blue Cross & Blue Shield of Rhode Island — HMO: $5,586.43
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $3,520.15
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $6,207.14
  • Blue Cross & Blue Shield of Rhode Island — PPO: $6,207.14
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $5,331.91
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $5,839.71
  • Neighborhood Health Plan of Rhode Island — Integrity: $3,627.15
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $1,257.52
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $3,554.61
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Ep Compre Electrophysiologic W/O Arrhyt Induction $5,473 $1,915.55 $81.74 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $14,049.58
Heart rhythm study (electrophysiology evaluation): 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $8,979.52
  • Blue Cross & Blue Shield of Rhode Island — HMO: $8,270.06
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $5,211.02
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $9,188.96
  • Blue Cross & Blue Shield of Rhode Island — PPO: $9,188.96
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $12,827.88
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $14,049.58
  • Neighborhood Health Plan of Rhode Island — Integrity: $8,726.45
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $1,310.66
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $8,551.92
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Ep Ephys Evl Trnsptl Tx Atrial Fib Isolat Pulm Vein $50,916 $17,820.60 $148.76 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $47,504.63
Heart rhythm study with ablation for atrial fibrillation: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $30,091.73
  • Blue Cross & Blue Shield of Rhode Island — HMO: $23,500.38
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $14,807.75
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $26,111.53
  • Blue Cross & Blue Shield of Rhode Island — PPO: $26,111.53
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $42,988.18
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $47,082.29
  • Neighborhood Health Plan of Rhode Island — Integrity: $29,243.66
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $1,565.38
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $28,658.79
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Polysom 6/>Yrs Sleep 4/> Addl Param Attnd $5,652 $1,978.20 $172.29 – $5,273.32
Sleep study (overnight, in a sleep lab): 10 of 23 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $988.64
  • Blue Cross & Blue Shield of Rhode Island — HMO: $1,652.97
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $1,071.02
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $1,836.63
  • Blue Cross & Blue Shield of Rhode Island — PPO: $1,836.63
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $1,412.35
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $1,546.86
  • Neighborhood Health Plan of Rhode Island — Integrity: $960.78
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $1,507.22
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $941.56

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt Therapeutic Exercises $149 $52.15 $26.15 – $417
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $30.62
  • Blue Cross & Blue Shield of Rhode Island — HMO: $65.57
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $36.54
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $72.85
  • Blue Cross & Blue Shield of Rhode Island — PPO: $72.85
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $43.75
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $47.91
  • Neighborhood Health Plan of Rhode Island — Integrity: $29.76
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $117.13
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $29.16
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Ot Therapeutic Exercises $149 $52.15 $26.15 – $417
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $30.62
  • Blue Cross & Blue Shield of Rhode Island — HMO: $65.57
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $36.54
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $72.85
  • Blue Cross & Blue Shield of Rhode Island — PPO: $72.85
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $43.75
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $47.91
  • Neighborhood Health Plan of Rhode Island — Integrity: $29.76
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $117.13
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $29.16
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt Physical Therapy Evaluation Low Complex 20 Mins $303 $106.05 $74.17 – $417
Physical therapy evaluation (low complexity): 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $103.59
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $147.98
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $162.08
  • Neighborhood Health Plan of Rhode Island — Integrity: $100.67
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $114.77
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $98.66
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $89.13
  • Tufts Health Public Plans — Managed Medicaid RI: $126.81
  • United Healthcare Insurance Company — Commercial: $417
  • United Healthcare Insurance Company — MANAGED MEDICARE: $98.66
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt Physical Therapy Evaluation Mod Complex 30 Mins $303 $106.05 $64.80 – $417
Physical therapy evaluation (moderate complexity): 10 of 26 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $103.59
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $147.98
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $162.08
  • Neighborhood Health Plan of Rhode Island — Integrity: $100.67
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $114.77
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $98.66
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $89.13
  • Tufts Health Public Plans — Managed Medicaid MA: $64.80
  • Tufts Health Public Plans — Managed Medicaid RI: $126.81
  • United Healthcare Insurance Company — Commercial: $417
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt Physical Therapy Evaluation High Complex 45 Mins $399 $139.65 $89.13 – $417
Physical therapy evaluation (high complexity): 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $103.59
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $147.98
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $162.08
  • Neighborhood Health Plan of Rhode Island — Integrity: $100.67
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $114.77
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $98.66
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $89.13
  • Tufts Health Public Plans — Managed Medicaid RI: $126.81
  • United Healthcare Insurance Company — Commercial: $417
  • United Healthcare Insurance Company — MANAGED MEDICARE: $98.66
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Psychotherapy Patient &/ Family 30 Minutes $327 $114.45 $27.03 – $357.86
Psychotherapy, 30 minutes: 10 of 23 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $204.35
  • Blue Cross & Blue Shield of Rhode Island — HMO: $169.90
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $110.09
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $188.78
  • Blue Cross & Blue Shield of Rhode Island — PPO: $188.78
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $291.93
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $319.73
  • Neighborhood Health Plan of Rhode Island — Integrity: $198.59
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $87.84
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $194.62
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: HC Psychotherapy Patient &/ Family 30 Minutes|PN - NON-EXCEPTED OFF-CAMPUS SVC $327 $114.45 $27.03 – $357.86
Psychotherapy, 30 minutes: 10 of 23 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $204.35
  • Blue Cross & Blue Shield of Rhode Island — HMO: $169.90
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $110.09
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $188.78
  • Blue Cross & Blue Shield of Rhode Island — PPO: $188.78
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $291.93
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $319.73
  • Neighborhood Health Plan of Rhode Island — Integrity: $198.59
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $87.84
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $194.62
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Psychotherapy Patient &/ Family 45 Minutes $432 $151.20 $34.25 – $403.06
Psychotherapy, 45 minutes: 10 of 23 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $204.35
  • Blue Cross & Blue Shield of Rhode Island — HMO: $225.89
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $146.36
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $250.99
  • Blue Cross & Blue Shield of Rhode Island — PPO: $250.99
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $291.93
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $319.73
  • Neighborhood Health Plan of Rhode Island — Integrity: $198.59
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $112.69
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $194.62
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: HC Psychotherapy Patient &/ Family 45 Minutes|PN - NON-EXCEPTED OFF-CAMPUS SVC $432 $151.20 $34.25 – $403.06
Psychotherapy, 45 minutes: 10 of 23 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $204.35
  • Blue Cross & Blue Shield of Rhode Island — HMO: $225.89
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $146.36
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $250.99
  • Blue Cross & Blue Shield of Rhode Island — PPO: $250.99
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $291.93
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $319.73
  • Neighborhood Health Plan of Rhode Island — Integrity: $198.59
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $112.69
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $194.62
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Psychotherapy Patient &/ Family 60 Minutes $432 $151.20 $34.25 – $518.82
Psychotherapy, 60 minutes: 10 of 23 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $204.35
  • Blue Cross & Blue Shield of Rhode Island — HMO: $225.89
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $146.36
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $250.99
  • Blue Cross & Blue Shield of Rhode Island — PPO: $250.99
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $291.93
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $319.73
  • Neighborhood Health Plan of Rhode Island — Integrity: $198.59
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $164.94
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $194.62
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Family Psychotherapy,No Pt $503 $176.05 $38.03 – $469.30
Family psychotherapy, without the patient: 10 of 23 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $204.35
  • Blue Cross & Blue Shield of Rhode Island — HMO: $262.90
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $170.34
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $292.11
  • Blue Cross & Blue Shield of Rhode Island — PPO: $292.11
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $291.93
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $319.73
  • Neighborhood Health Plan of Rhode Island — Integrity: $198.59
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $194.62
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $101.78
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Family Psychotherapy W Phys $503 $176.05 $38.03 – $1,194.23
Family psychotherapy, with the patient: 10 of 23 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $204.35
  • Blue Cross & Blue Shield of Rhode Island — HMO: $262.90
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $170.34
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $292.11
  • Blue Cross & Blue Shield of Rhode Island — PPO: $292.11
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $291.93
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $319.73
  • Neighborhood Health Plan of Rhode Island — Integrity: $198.59
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $194.62
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $106.14
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Group Psychotherapy $240 $84 $19.24 – $496.50
Group psychotherapy: 10 of 23 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $116.96
  • Blue Cross & Blue Shield of Rhode Island — HMO: $124.39
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $80.59
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $138.21
  • Blue Cross & Blue Shield of Rhode Island — PPO: $138.21
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $167.08
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $182.99
  • Neighborhood Health Plan of Rhode Island — Integrity: $113.66
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $111.39
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $24.98

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Excise Breast Cyst $3,304 $1,156.40 $1,272.81 – $7,052.89
Removal of breast growth (open surgery): 10 of 22 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $4,507.72
  • Blue Cross & Blue Shield of Rhode Island — HMO: $3,927.59
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $2,474.88
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $4,363.99
  • Blue Cross & Blue Shield of Rhode Island — PPO: $4,363.99
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $6,439.60
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $7,052.89
  • Neighborhood Health Plan of Rhode Island — Integrity: $4,380.68
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $2,910
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $4,293.07
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Esophagogastroduodenoscopy Transoral Diagnostic - Egd $959 $335.65 $0.05 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,910
Upper GI endoscopy (diagnostic): 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $1,044.18
  • Blue Cross & Blue Shield of Rhode Island — HMO: $1,314.52
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $828.32
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $1,460.58
  • Blue Cross & Blue Shield of Rhode Island — PPO: $1,460.58
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $1,491.68
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $1,633.75
  • Neighborhood Health Plan of Rhode Island — Integrity: $1,014.75
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $2,910
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $994.46
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Egd Transoral Biopsy Single/Multiple - Egd $853 $298.55 $13.06 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,910
Upper GI endoscopy with biopsy: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $1,044.18
  • Blue Cross & Blue Shield of Rhode Island — HMO: $1,314.52
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $828.32
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $1,460.58
  • Blue Cross & Blue Shield of Rhode Island — PPO: $1,460.58
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $1,491.68
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $1,633.75
  • Neighborhood Health Plan of Rhode Island — Integrity: $1,014.75
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $2,910
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $994.46
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Flx Dx W/Collj Spec When Pfrmd - Colonoscopy $1,703 $596.05 $13.93 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,910
Colonoscopy (diagnostic): 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $1,070.63
  • Blue Cross & Blue Shield of Rhode Island — HMO: $1,457.62
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $918.49
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $1,619.58
  • Blue Cross & Blue Shield of Rhode Island — PPO: $1,619.58
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $1,529.48
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $1,675.14
  • Neighborhood Health Plan of Rhode Island — Integrity: $1,040.46
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $2,910
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $1,019.65
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy W/Biopsy Single/Multiple - Colonoscopy $1,279 $447.65 $13.93 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,910
Colonoscopy with biopsy: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $1,377.66
  • Blue Cross & Blue Shield of Rhode Island — HMO: $1,457.62
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $918.49
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $1,619.58
  • Blue Cross & Blue Shield of Rhode Island — PPO: $1,619.58
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $1,968.08
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $2,155.52
  • Neighborhood Health Plan of Rhode Island — Integrity: $1,338.83
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $2,910
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $1,312.05
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq - Colonoscopy $1,279 $447.65 $1.27 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,910
Colonoscopy with removal of polyps (snare): 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $1,377.66
  • Blue Cross & Blue Shield of Rhode Island — HMO: $1,457.62
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $918.49
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $1,619.58
  • Blue Cross & Blue Shield of Rhode Island — PPO: $1,619.58
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $1,968.08
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $2,155.52
  • Neighborhood Health Plan of Rhode Island — Integrity: $1,338.83
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $2,910
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $1,312.05
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pbb Colon Ca Scrn Not Hi Rsk Ind $2,260 $791 $8.20 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,910
Screening colonoscopy (not high risk): 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $1,070.63
  • Blue Cross & Blue Shield of Rhode Island — HMO: $1,289.90
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $812.77
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $1,433.22
  • Blue Cross & Blue Shield of Rhode Island — PPO: $1,433.22
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $1,529.48
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $1,675.14
  • Neighborhood Health Plan of Rhode Island — Integrity: $1,040.46
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $2,910
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $1,019.65
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Hysteroscopy,W/Endo Bx $3,276 $1,146.60 $1,254.38 – $5,831.05
Hysteroscopy with biopsy of the uterus lining: 10 of 23 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $3,726.80
  • Blue Cross & Blue Shield of Rhode Island — HMO: $3,546.56
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $2,234.78
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $3,940.62
  • Blue Cross & Blue Shield of Rhode Island — PPO: $3,940.62
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $5,324
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $5,831.05
  • Neighborhood Health Plan of Rhode Island — Integrity: $3,621.77
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $3,549.33
  • Tufts Health Public Plans — Managed Medicaid MA: $1,846.31
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Njx Aa&/Strd Tfrml Epi Lumbar/Sacral Level 1 $1,544 $540.40 $41.11 – $2,910
Nerve root injection, lower back, with imaging guidance: 10 of 25 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $1,018.27
  • Blue Cross & Blue Shield of Rhode Island — HMO: $1,192.87
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $751.66
  • Blue Cross & Blue Shield of Rhode Island — OUT OF STATE: $1,325.41
  • Blue Cross & Blue Shield of Rhode Island — PPO: $1,325.41
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $1,454.67
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $1,593.21
  • Neighborhood Health Plan of Rhode Island — Integrity: $989.57
  • Neighborhood Health Plan of Rhode Island — Managed Medicaid: $2,910
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $969.78

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC Not listed in the file Not listed in the file $45.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $92.30 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 16 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $84,602.72
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $120,861.03
  • Connecticare, Inc — COMMERCIAL: $4,150
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $96,195.51
  • Neighborhood Health Plan of Rhode Island — MANAGED MEDICARE: $82,218.39
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $80,574.02
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $104,935.11
  • United Healthcare Insurance Company — Managed Medicaid: $1,938
  • United Healthcare Insurance Company — MANAGED MEDICARE: $80,574.02
  • WELLCARE — MANAGED MEDICARE: $83,796.98
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE & OTHER MAJOR CARDIOTHORACIC PROCEDURES W CARDIAC CATHETERIZATION W MCC Not listed in the file Not listed in the file $1,938 – $104,935.11
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 2 insurance plans
  • United Healthcare Insurance Company — Commercial: $24,083
  • United Healthcare Insurance Company — Nexus: $22,879
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC Not listed in the file Not listed in the file $1,938 – $104,935.11
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 1 insurance plan
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $68,228.75
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL W/O MCC Not listed in the file Not listed in the file $28,947.25
Spinal fusion (not neck), without major complications: rates for 1 insurance plan
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $28,947.25
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Not listed in the file Not listed in the file $2,015
Spinal fusion (not neck), without major complications: rates for 1 insurance plan
  • United Healthcare Insurance Company — Managed Medicaid: $2,015
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC Not listed in the file Not listed in the file $45.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $92.30 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Hip or knee replacement (major joint of the leg), without major complications: 10 of 16 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $17,113.85
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $24,448.35
  • Connecticare, Inc — COMMERCIAL: $4,150
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $19,458.89
  • Neighborhood Health Plan of Rhode Island — MANAGED MEDICARE: $16,631.53
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $16,298.90
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $19,833.39
  • United Healthcare Insurance Company — Managed Medicaid: $2,015
  • United Healthcare Insurance Company — MANAGED MEDICARE: $16,298.90
  • WELLCARE — MANAGED MEDICARE: $16,950.86
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP & KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC Not listed in the file Not listed in the file $15,447.03 – $24,078
Hip or knee replacement (major joint of the leg), without major complications: rates for 2 insurance plans
  • United Healthcare Insurance Company — Commercial: $24,078
  • United Healthcare Insurance Company — Nexus: $22,874
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC Not listed in the file Not listed in the file $15,447.03 – $24,078
Hip or knee replacement (major joint of the leg), without major complications: rates for 1 insurance plan
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $15,447.03
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Not listed in the file Not listed in the file $45.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $92.30 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Neck (cervical) spinal fusion, without complications: 10 of 16 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $21,516.92
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $30,738.46
  • Connecticare, Inc — COMMERCIAL: $4,150
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $24,465.30
  • Neighborhood Health Plan of Rhode Island — MANAGED MEDICARE: $20,910.52
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $20,492.31
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $21,540.34
  • United Healthcare Insurance Company — Managed Medicaid: $2,015
  • United Healthcare Insurance Company — MANAGED MEDICARE: $20,492.31
  • WELLCARE — MANAGED MEDICARE: $21,312
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION W/O CC/MCC Not listed in the file Not listed in the file $16,163.13 – $24,465.30
Neck (cervical) spinal fusion, without complications: rates for 3 insurance plans
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $16,163.13
  • United Healthcare Insurance Company — Commercial: $24,078
  • United Healthcare Insurance Company — Nexus: $22,874
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Not listed in the file Not listed in the file $45.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $92.30 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Uterus and ovary surgery (not for cancer), without complications: 10 of 16 insurance plan rates
  • AETNA HEALTH MANAGEMENT, LLC — MANAGED MEDICARE: $11,200.12
  • Blue Cross & Blue Shield of Rhode Island — Prime EPO: $16,000.17
  • Connecticare, Inc — COMMERCIAL: $4,150
  • Neighborhood Health Plan of Rhode Island — COMMERCIAL: $12,734.83
  • Neighborhood Health Plan of Rhode Island — MANAGED MEDICARE: $10,884.47
  • TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. — DIRECT: $10,666.78
  • Tufts Associated Health Maintenance Organization, Inc. — USHFP: $12,065.70
  • United Healthcare Insurance Company — Managed Medicaid: $2,015
  • United Healthcare Insurance Company — MANAGED MEDICARE: $10,666.78
  • WELLCARE — MANAGED MEDICARE: $11,093.45
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE & ADNEXA PROCEDURES FOR NON-MALIGNANCY W/O CC/MCC Not listed in the file Not listed in the file $7,127.24 – $24,078
Uterus and ovary surgery (not for cancer), without complications: rates for 2 insurance plans
  • United Healthcare Insurance Company — Commercial: $24,078
  • United Healthcare Insurance Company — Nexus: $22,874
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC Not listed in the file Not listed in the file $7,127.24 – $24,078
Uterus and ovary surgery (not for cancer), without complications: rates for 1 insurance plan
  • Blue Cross & Blue Shield of Rhode Island — MANAGED MEDICARE: $7,127.24

Source: Kent County Memorial Hospital’s standard charges file (carenewengland.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on February 28, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital typeAcute Care Hospital
Address455 Toll Gate Rd, Warwick, RI 02886
CountyKent County
StateRhode Island
Phone(401) 737‑7010
Emergency servicesYes
OwnershipProprietary
Medicare overall rating3 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number410009
Name in Medicare recordsKENT COUNTY MEMORIAL HOSPITAL
Profile levelMedicare data + hospital website
Name on the hospital’s websiteKent Hospital
Official websitekentri.org
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
  2. Medicare Care Compare — official Medicare profile of this hospital
  3. U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

  1. Kent Hospital — kentri.org
  2. Emergency Care — kentri.org
  3. Stroke Care — kentri.org
  4. Directions — carenewengland.org
  5. X-Ray Testing & Diagnosis Services | Kent Hospital — kentri.org
  6. Interventional Radiology at Kent Hospital | Rhode Island — kentri.org
  7. Spaulding Joint Health Program | Kent Hospital in Rhode Island — kentri.org
  8. The Advanced Primary Stroke Center at Kent Hospital — kentri.org
  9. Inpatient Rehabilitation at Kent Hospital in Rhode Island — kentri.org
  10. Stroke Specialty Program | Kent Hospital in Rhode Island — kentri.org
  11. Amputee Specialty Unit | Kent Hospital in Rhode Island — kentri.org
  12. Cancer Care Programs | Kent Hospital — kentri.org
  13. Diagnostic Imaging Center | Kent Hospital — kentri.org
  14. Acute Care for Elders Inpatient Unit at Kent Hospital — kentri.org
  15. Lung Health Clinic at Kent Hospital | Rhode Island — kentri.org
  16. Pregnancy & Childbirth | Obstetrics at Kent Hospital — kentri.org