facebook tracking Level 5 Urology and Related Services cost in Rhode Island: 7 hospitals compared (APC 5375)

Level 5 Urology and Related Services in Rhode Island

What 7 hospitals in Rhode Island charged and were paid for level 5 urology and related services (APC 5375), from 2024 Medicare claims.

APC 5375 Outpatient 2024 Medicare data
Average charge $14,245 Hospital list price billed
Average allowed $5,229 Medicare's payment + patient's share
Medicare paid $4,160 Average per service
State rank #39 of 49 1 = lowest average payment

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.

Paid $5,229Billed $14,245

About 37¢ was paid for every $1 hospitals in Rhode Island billed for this service.

Rhode Island hospitals: level 5 urology and related services

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
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Lowest and highest allowed amounts in Rhode Island

Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Lowest

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

Highest

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

Level 5 Urology and Related Services in other states

Questions

How much does level 5 urology and related services cost in Rhode Island?

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.

Why are hospital charges so much higher than payments?

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.