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Rhode Island

Cost of a ER Visit (Low) Visit
in Rhode Island

Reviewed by Momentary Medical Group West PC

Rhode Island's concentrated healthcare market, dominated by just a few major health systems, creates unique pricing dynamics for emergency care across the Ocean State. Patients seeking a ER Visit (Low) typically pay between $40 and $204, with a median out-of-pocket cost of $88 based on negotiated insurance rates from 116 active providers statewide. Rhode Island's small geographic footprint means patients can browse all providers in the state within a reasonable travel distance.

Average

$111

Median

$88

Lowest

$40

Highest

$204

Providers

116

National avg: $94Rhode Island: $111

18% above national average

Compare Similar Procedures

How does er visit (low severity) compare to related procedures in Rhode Island?

ProcedureCPTLowMedianHighProviders
ER Visit (Moderate Severity)

Emergency department visit, moderate severity

99284$62$94$374121
ER Visit (High Severity)

Emergency department visit, high severity

99285$80$98$429113

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 99283Emergency department visit, low to moderate 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 99283 covers

Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 99283 (Emergency department visit, low to moderate severity), as mandated by the CMS Price Transparency Rule.

What CPT 99283 covers: the provider's professional fee for er visit (low 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 (Low) Visit Costs Vary Across Rhode Island

Rhode Island's emergency care costs run approximately 13% above national averages, reflecting the state's higher cost of living and concentrated healthcare market. The Ocean State's small size creates unique dynamics where most residents live within 30 minutes of multiple emergency care options.

Urban vs. Rural Provider Availability

Providence and surrounding urban areas offer multiple emergency departments and urgent care centers, creating some competitive pricing pressure. Rural communities in western and southern Rhode Island have fewer options, potentially leading to higher costs due to limited competition. The state's compact geography means rural residents can often access urban providers within reasonable travel times.

Facility Type and Overhead Costs

Hospital-based emergency departments operated by major health systems like Lifespan and Care New England typically carry higher overhead costs than freestanding urgent care centers. Academic medical centers such as Rhode Island Hospital command premium pricing due to their teaching hospital status and specialized capabilities. Independent urgent care facilities often provide lower-cost alternatives for non-emergency conditions.

Insurance Market Competition in Rhode Island

The state's insurance market features moderate competition among Blue Cross Blue Shield of Rhode Island, UnitedHealthCare, and Tufts Health Plan, with BCBS maintaining the largest market share. This concentrated payer environment can limit negotiating power for smaller providers while giving major health systems stronger rate negotiations. Limited insurer options may result in less competitive negotiated rates compared to states with more diverse insurance markets.

Physician Supply and Demand in Rhode Island

With 116 active emergency care providers serving approximately 1.1 million residents, Rhode Island maintains adequate emergency physician supply relative to its population. The state's medical schools and residency programs help maintain steady physician recruitment, though competition with higher-paying markets like Boston can create retention challenges. Sufficient provider supply generally helps moderate pricing compared to physician-shortage areas.

JP

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.

Healthcare Data AnalyticsCMS TiC DataInsurance Price Transparency

Frequently Asked Questions — ER Visit (Low) Costs in Rhode Island

What is the average cost of a ER Visit (Low) visit in Rhode Island without insurance?

Without insurance, a low-severity emergency visit in Rhode Island typically costs between $40 and $204, with a median cost of $88 based on negotiated rates from 116 providers. Self-pay patients often receive discounts of 20-40% when paying at the time of service. Many hospitals offer financial assistance programs and payment plans to help manage these costs.

Does Rhode Island Medicaid cover ER Visit (Low) visits?

Yes, Rhode Island's expanded Medicaid program covers emergency visits for eligible residents, including adults up to 138% of the federal poverty level. Coverage includes both emergency department visits and urgent care when medically appropriate. Patients should bring their Medicaid card and may have minimal copays depending on their specific coverage level.

How do I find an affordable ER Visit (Low) near me in Rhode Island?

Compare costs between hospital emergency departments and urgent care centers, as urgent care often costs significantly less for non-emergency conditions. Look for community health centers and federally qualified health centers that offer sliding-scale fees based on income. Many providers offer self-pay discounts and payment plans for uninsured patients.

What is the difference in cost between an initial consultation and a follow-up visit?

Emergency departments typically use the same billing structure regardless of whether it's your first visit or a return visit, with costs based on the complexity and resources required for your specific condition. The median cost of $88 applies to the emergency visit itself. Follow-up care is usually handled through primary care physicians or specialists at significantly lower costs than repeat emergency visits.

Can I use an HSA or FSA to pay for a ER Visit (Low) visit in Rhode Island?

Yes, emergency room visits qualify as eligible medical expenses for both Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA). You can use these tax-advantaged funds to pay for copays, deductibles, and any portion of the emergency visit not covered by insurance. Keep receipts and documentation for tax purposes and FSA reimbursement claims.

How does telemedicine affect the cost of seeing a ER Visit (Low) in Rhode Island?

Telemedicine cannot replace in-person emergency care for most conditions requiring immediate evaluation and treatment. However, virtual urgent care consultations cost significantly less than emergency visits and can help determine whether you need immediate in-person care. Rhode Island providers increasingly offer telehealth triage services to help patients decide on the most appropriate level of care.

Click a state to compare costs

Average Visit Cost

$56
$271

Office visit (CPT 99283)

Compare With Other States

RankStateAverage
1Pennsylvania
Range: $47$693
$271
2Wisconsin
Range: $56$355
$180
3Illinois
Range: $57$252
$133
4Maine
Range: $86$184
$131
5New Hampshire
Range: $59$204
$130
6Michigan
Range: $54$252
$126
7Iowa
Range: $44$218
$119
8Rhode Island
Range: $40$204
$111
9California
Range: $80$153
$107
10Vermont
Range: $53$171
$107
11Indiana
Range: $57$171
$105
12New York
Range: $47$202
$105
13Washington
Range: $57$167
$101
14Colorado
Range: $54$159
$99
15Wyoming
Range: $54$155
$97
16Idaho
Range: $60$142
$96
17Nebraska
Range: $44$171
$95
18Massachusetts
Range: $40$206
$95
19Utah
Range: $53$139
$93
20District of Columbia
Range: $49$142
$92
21Maryland
Range: $43$162
$91
22Connecticut
Range: $53$153
$90
23Georgia
Range: $53$143
$90
24Alaska
Range: $69$118
$89
25New Mexico
Range: $54$139
$88
26Kentucky
Range: $40$139
$88
27Hawaii
Range: $54$139
$87
28Texas
Range: $54$118
$86
29North Carolina
Range: $51$136
$85
30New Jersey
Range: $44$142
$84
31South Carolina
Range: $51$128
$83
32Arkansas
Range: $51$115
$81
33Nevada
Range: $60$108
$81
34Alabama
Range: $49$131
$80
35Virginia
Range: $47$119
$79
36Arizona
Range: $53$107
$77
37Ohio
Range: $43$117
$77
38Minnesota
Range: $40$145
$75
39Tennessee
Range: $51$105
$75
40Oklahoma
Range: $51$104
$75
41Delaware
Range: $60$90
$74
42Missouri
Range: $52$99
$74
43Mississippi
Range: $51$104
$73
44Montana
Range: $40$91
$70
45Kansas
Range: $51$91
$70
46Florida
Range: $35$110
$67
47West Virginia
Range: $40$115
$65
48Louisiana
Range: $40$87
$63
49Oregon
Range: $40$108
$63
50North Dakota
Range: $40$91
$57
51South Dakota
Range: $40$88
$56
ER Visit (Low Severity) in Other States