What 7 hospitals in Rhode Island charged and were paid for level 5 urology and related services (APC 5375), from 2024 Medicare claims.
Hospitals in Rhode Island billed an average of $14,245 for level 5 urology and related services, about 2.7 times the average medicare-allowed amount of $5,229. That payment is 6% above the U.S. average of $4,934.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
About 37¢ was paid for every $1 hospitals in Rhode Island billed for this service.
Every Rhode Island hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Miriam HospitalProvidence | 193 | $12,888 | $5,229 | $4,161 |
| Westerly HospitalWesterly | 88 | $16,580 | $5,179 | $4,111 |
| South County Hospital INCWakefield | 80 | $14,927 | $5,251 | $4,184 |
| Our Lady of Fatima HospitalNorth Providence | 48 | $13,951 | $5,251 | $4,184 |
| Rhode Island HospitalProvidence | 30 | $11,354 | $5,251 | $4,184 |
| Kent County Memorial HospitalWarwick | 29 | $13,244 | $5,251 | $4,176 |
| Landmark Medical Center, INCWoonsocket | 11 | $26,223 | $5,251 | $4,167 |
Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
| Westerly HospitalWesterly, RI | $5,179 |
|---|---|
| Miriam HospitalProvidence, RI | $5,229 |
| Our Lady of Fatima HospitalNorth Providence, RI | $5,251 |
| Rhode Island HospitalProvidence, RI | $5,251 |
| South County Hospital INCWakefield, RI | $5,251 |
| Landmark Medical Center, INCWoonsocket, RI | $5,251 |
|---|---|
| Kent County Memorial HospitalWarwick, RI | $5,251 |
| Our Lady of Fatima HospitalNorth Providence, RI | $5,251 |
| Rhode Island HospitalProvidence, RI | $5,251 |
| South County Hospital INCWakefield, RI | $5,251 |
In 2024 Medicare data, level 5 urology and related services (APC 5375) at 7 hospitals in Rhode Island was billed at $14,245 on average, while the average medicare-allowed amount was $5,229, of which Medicare paid $4,160. Your own cost depends on your insurance, deductible and the hospital.
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this service in Rhode Island, average charges were 2.7 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Outpatient Hospitals by Provider and Service, 2024. The allowed amount is Medicare's payment plus the patient's coinsurance. CMS omits hospitals with fewer than 11 services for privacy. About the data.