Cost of a ER Visit (Moderate) Visit
in Rhode Island
Reviewed by Momentary Medical Group West PC
Rhode Island's small size and concentrated healthcare market, dominated by just a few major health systems, creates unique pricing dynamics for emergency care. For an ER Visit (Moderate), patients typically pay between $62 and $374, with a median out-of-pocket cost of $94 based on negotiated insurance rates. The state has 121 active emergency providers, giving patients options across Providence, Newport, and Warwick to browse all providers in Rhode Island.
Average
$177
Median
$94
Lowest
$62
Highest
$374
Providers
121
24% above national average
Compare Similar Procedures
How does er visit (moderate 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 (High Severity) Emergency department visit, high severity | 99285 | $80 | $98 | $429 | 113 |
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 99284 — Emergency department visit, 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 99284 covers
Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 99284 (Emergency department visit, moderate severity), as mandated by the CMS Price Transparency Rule.
What CPT 99284 covers: the provider's professional fee for er visit (moderate 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 (Moderate) Visit Costs Vary Across Rhode Island
Rhode Island's healthcare costs run approximately 13% above the national average, reflecting the state's high cost of living and concentrated provider market. The Ocean State's small geography means most residents can access Providence's major medical centers, but this concentration limits price competition among emergency providers.
Urban vs. Rural Provider Availability
Most of Rhode Island's emergency capacity centers around Providence and its suburbs, with major facilities like Rhode Island Hospital and The Miriam Hospital serving the metro area. Coastal communities like Newport and Westerly rely on smaller community hospitals that may have higher per-visit costs due to lower patient volumes. The state's compact size means rural areas are within reasonable distance of urban emergency care, but local facilities often charge premium rates.
Facility Type and Overhead Costs
Lifespan health system controls many of Rhode Island's major emergency departments, creating less price variation than states with more fragmented hospital ownership. Academic medical centers like Rhode Island Hospital typically charge higher facility fees than community hospitals due to their teaching mission and advanced capabilities. Independent emergency centers are less common in Rhode Island compared to larger states, limiting lower-cost alternatives.
Insurance Market Competition in Rhode Island
The dominance of Blue Cross Blue Shield of Rhode Island, along with United Healthcare and Tufts Health Plan, creates a relatively concentrated insurance market with limited premium competition. This concentration can lead to stronger negotiated rates with major health systems but fewer plan options for consumers. Small group and individual market competition remains limited compared to larger states with more insurer participation.
Physician Supply and Demand in Rhode Island
With 121 active emergency medicine providers serving roughly 1.1 million residents, Rhode Island maintains adequate emergency physician coverage relative to its population. The state's proximity to major medical schools in Boston helps recruit emergency medicine physicians, though retention can be challenging due to higher salaries in nearby Massachusetts. Adequate physician supply helps prevent the extreme pricing seen in physician-shortage areas.
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 (Moderate) Costs in Rhode Island
What is the average cost of a ER Visit (Moderate) visit in Rhode Island without insurance?
Does Rhode Island Medicaid cover ER Visit (Moderate) visits?
How do I find an affordable ER Visit (Moderate) 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 (Moderate) visit in Rhode Island?
How does telemedicine affect the cost of seeing a ER Visit (Moderate) in Rhode Island?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 99284)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $73 – $647 | $311 |
| 2 | Illinois Range: $80 – $431 | $223 |
| 3 | Iowa Range: $80 – $371 | $205 |
| 4 | New Hampshire Range: $102 – $307 | $202 |
| 5 | Pennsylvania Range: $55 – $431 | $191 |
| 6 | New York Range: $67 – $374 | $183 |
| 7 | Rhode Island Range: $62 – $374 | $177 |
| 8 | Maine Range: $116 – $233 | $172 |
| 9 | Massachusetts Range: $62 – $368 | $170 |
| 10 | Nebraska Range: $83 – $291 | $165 |
| 11 | Washington Range: $80 – $259 | $161 |
| 12 | Michigan Range: $80 – $291 | $158 |
| 13 | New Mexico Range: $85 – $266 | $158 |
| 14 | Wyoming Range: $85 – $262 | $157 |
| 15 | Colorado Range: $80 – $267 | $157 |
| 16 | Vermont Range: $80 – $257 | $156 |
| 17 | Georgia Range: $84 – $246 | $151 |
| 18 | California Range: $80 – $258 | $142 |
| 19 | Indiana Range: $80 – $258 | $142 |
| 20 | Kentucky Range: $70 – $246 | $140 |
| 21 | North Carolina Range: $80 – $231 | $139 |
| 22 | District of Columbia Range: $80 – $217 | $138 |
| 23 | West Virginia Range: $62 – $174 | $137 |
| 24 | Utah Range: $80 – $228 | $135 |
| 25 | Maryland Range: $80 – $206 | $132 |
| 26 | New Jersey Range: $60 – $237 | $131 |
| 27 | Hawaii Range: $80 – $217 | $130 |
| 28 | Arkansas Range: $80 – $194 | $130 |
| 29 | Virginia Range: $81 – $202 | $129 |
| 30 | Tennessee Range: $85 – $187 | $128 |
| 31 | South Carolina Range: $80 – $206 | $128 |
| 32 | Ohio Range: $75 – $197 | $127 |
| 33 | Missouri Range: $85 – $167 | $124 |
| 34 | Alabama Range: $80 – $195 | $124 |
| 35 | Oklahoma Range: $85 – $169 | $123 |
| 36 | Kansas Range: $86 – $167 | $123 |
| 37 | Texas Range: $80 – $196 | $122 |
| 38 | Arizona Range: $80 – $187 | $122 |
| 39 | Mississippi Range: $86 – $165 | $121 |
| 40 | Idaho Range: $80 – $194 | $121 |
| 41 | Delaware Range: $80 – $157 | $120 |
| 42 | Minnesota Range: $62 – $233 | $119 |
| 43 | Nevada Range: $84 – $184 | $119 |
| 44 | Connecticut Range: $55 – $211 | $118 |
| 45 | Alaska Range: $80 – $194 | $118 |
| 46 | Louisiana Range: $62 – $150 | $104 |
| 47 | Oregon Range: $62 – $183 | $102 |
| 48 | Montana Range: $62 – $145 | $96 |
| 49 | Florida Range: $35 – $190 | $95 |
| 50 | North Dakota Range: $62 – $121 | $82 |
| 51 | South Dakota Range: $62 – $121 | $82 |