Cost of a ER Visit (High) Visit
in Rhode Island
Reviewed by Momentary Medical Group West PC
Rhode Island's compact geography means emergency care is relatively accessible, yet the state's ER Visit (High) costs run approximately 13% above national averages. Patients requiring high-severity emergency care typically pay between $80 and $429, with a median out-of-pocket cost of $98 based on negotiated insurance rates. Rhode Island maintains 113 active ER Visit (High) providers across the state's 39 cities, from Providence Medical Center to Newport Hospital, giving patients multiple options when emergency situations arise.
Average
$202
Median
$98
Lowest
$80
Highest
$429
Providers
113
7% above national average
Compare Similar Procedures
How does er visit (high severity) compare to related procedures in Rhode Island?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| ER Visit (Low Severity) Emergency department visit, low severity | 99283 | $40 | $88 | $204 | 116 |
| ER Visit (Moderate Severity) Emergency department visit, moderate severity | 99284 | $62 | $94 | $374 | 121 |
Important: These are cost estimates only — not a quote and not medical advice.
The prices on this page are self-pay rates, drawn from federal Transparency in Coverage machine-readable files (CPT 99285 — Emergency department visit, high severity). They represent what a patient might pay without insurance.
Your actual cost depends on: your specific insurance plan, your remaining deductible, your coinsurance percentage, whether you have met your out-of-pocket maximum, whether the facility and provider are both in-network, and any separate anesthesia or implant fees billed independently.
This page does not constitute medical advice. Whether you need this procedure, and which approach is right for you, is a decision to make with a licensed healthcare provider.
Where this data comes from & what CPT 99285 covers
Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 99285 (Emergency department visit, high severity), as mandated by the CMS Price Transparency Rule.
What CPT 99285 covers: the provider's professional fee for er visit (high severity). It does not include facility/hospital fees, anesthesia, pre-operative imaging, post-operative care, or any add-on codes billed separately.
How to read this data
Negotiated Rate
The discounted price an insurer has agreed to pay a specific provider. Most insured patients' bills are calculated from this number, not the higher list price hospitals publish separately.
P5, Median, P95
P5 is the rate at the 5th percentile (low end), Median is the middle value, and P95 is the 95th percentile (high end). This range shows how much the same visit can vary between providers.
What this does not tell you
These rates do not tell you what you personally will pay out of pocket. That depends on your specific plan, how much of your deductible you have already met, your coinsurance rate, and whether the provider is in your network. Call your insurer's member line to get your exact estimate.
Why ER Visit (High) Visit Costs Vary Across Rhode Island
Rhode Island's emergency care costs run approximately 13% above national averages, reflecting the state's high cost of living and concentrated population requiring sophisticated medical infrastructure. The Ocean State's small geographic footprint means most residents can reach advanced emergency care within 30 minutes, but this accessibility comes with premium pricing typical of Northeast healthcare markets.
Urban vs. Rural Provider Availability
Providence and its surrounding suburbs concentrate the majority of high-level emergency services, including the state's only Level I trauma center at Rhode Island Hospital. Coastal communities like Newport and Westerly maintain full-service emergency departments, but complex cases often require transfer to Providence-area facilities. The state's compact size means rural access issues are less pronounced than in larger states, though island communities face unique transport challenges.
Facility Type and Overhead Costs
Hospital-based emergency departments dominate Rhode Island's emergency care landscape, with major health systems like Lifespan and Care New England operating most facilities and commanding premium pricing. Independent emergency physicians are rare, as most work for large physician groups contracted with hospital systems, reducing price competition. Academic medical centers affiliated with Brown University's medical school typically charge higher facility fees due to teaching hospital overhead and complex case mix.
Insurance Market Competition in Rhode Island
The state's insurance market features moderate competition between BCBS RI, UnitedHealthcare, and Tufts Health Plan, though BCBS RI maintains the largest market share and strongest hospital relationships. Limited insurer options mean hospitals have significant negotiating power, contributing to higher emergency care costs compared to more competitive markets. State employees and retirees represent a large covered population, influencing rate negotiations across major health systems.
Physician Supply and Demand in Rhode Island
Rhode Island's 113 active ER Visit (High) providers serve a population of just over one million, indicating adequate emergency physician supply relative to most states. The presence of Brown University's emergency medicine residency program helps maintain physician recruitment, though competition from higher-paying markets in Boston and New York can create staffing challenges. Adequate provider supply helps maintain reasonable wait times, though it hasn't significantly reduced emergency care pricing due to facility overhead costs.
Jayant Panwar
CEO, Momentary Labs · San Francisco, CA
Jayant has analyzed healthcare pricing data from CMS Transparency in Coverage files since 2022, covering more than 50 million negotiated rate records across all 50 states. His work focuses on making insurer machine-readable files accessible to patients and researchers.
The cost figures on this page reflect his ongoing work to make this data accessible to patients.
Frequently Asked Questions — ER Visit (High) Costs in Rhode Island
What is the average cost of a ER Visit (High) visit in Rhode Island without insurance?
Does Rhode Island Medicaid cover ER Visit (High) visits?
How do I find an affordable ER Visit (High) near me in Rhode Island?
What is the difference in cost between an initial consultation and a follow-up visit?
Can I use an HSA or FSA to pay for a ER Visit (High) visit in Rhode Island?
How does telemedicine affect the cost of seeing a ER Visit (High) in Rhode Island?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 99285)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $73 – $940 | $430 |
| 2 | New Hampshire Range: $150 – $446 | $294 |
| 3 | Illinois Range: $80 – $569 | $285 |
| 4 | Iowa Range: $85 – $538 | $275 |
| 5 | Louisiana Range: $98 – $536 | $261 |
| 6 | New York Range: $80 – $543 | $260 |
| 7 | Maine Range: $170 – $337 | $251 |
| 8 | Nebraska Range: $123 – $422 | $236 |
| 9 | Washington Range: $80 – $379 | $224 |
| 10 | Colorado Range: $80 – $390 | $219 |
| 11 | New Mexico Range: $88 – $389 | $218 |
| 12 | Wyoming Range: $88 – $385 | $217 |
| 13 | Vermont Range: $98 – $356 | $216 |
| 14 | Rhode Island Range: $80 – $429 | $202 |
| 15 | Massachusetts Range: $80 – $428 | $202 |
| 16 | Georgia Range: $85 – $333 | $198 |
| 17 | North Carolina Range: $80 – $330 | $188 |
| 18 | District of Columbia Range: $85 – $305 | $185 |
| 19 | Maryland Range: $88 – $298 | $183 |
| 20 | Michigan Range: $80 – $318 | $183 |
| 21 | Utah Range: $80 – $317 | $182 |
| 22 | New Jersey Range: $60 – $348 | $182 |
| 23 | Ohio Range: $85 – $287 | $181 |
| 24 | Mississippi Range: $126 – $250 | $181 |
| 25 | California Range: $80 – $374 | $181 |
| 26 | Hawaii Range: $80 – $313 | $179 |
| 27 | Arkansas Range: $85 – $282 | $178 |
| 28 | Virginia Range: $88 – $293 | $177 |
| 29 | Tennessee Range: $85 – $259 | $170 |
| 30 | South Carolina Range: $80 – $287 | $170 |
| 31 | Missouri Range: $88 – $239 | $168 |
| 32 | Minnesota Range: $91 – $312 | $167 |
| 33 | Oklahoma Range: $85 – $246 | $166 |
| 34 | Kansas Range: $88 – $243 | $166 |
| 35 | Alabama Range: $80 – $257 | $160 |
| 36 | Pennsylvania Range: $55 – $334 | $159 |
| 37 | Arizona Range: $80 – $250 | $157 |
| 38 | Indiana Range: $85 – $298 | $157 |
| 39 | West Virginia Range: $88 – $281 | $155 |
| 40 | Delaware Range: $85 – $203 | $155 |
| 41 | Kentucky Range: $80 – $296 | $155 |
| 42 | Nevada Range: $85 – $267 | $154 |
| 43 | Alaska Range: $80 – $292 | $151 |
| 44 | Connecticut Range: $55 – $320 | $148 |
| 45 | Idaho Range: $80 – $275 | $148 |
| 46 | Oregon Range: $80 – $250 | $142 |
| 47 | Texas Range: $80 – $257 | $142 |
| 48 | Montana Range: $80 – $213 | $124 |
| 49 | North Dakota Range: $91 – $177 | $122 |
| 50 | South Dakota Range: $98 – $161 | $119 |
| 51 | Florida Range: $35 – $246 | $114 |