Rhode Island · 77427

Radiation Treatment Management, 5 Treatment Sessions in Rhode Island

Rhode Island Medicare Avg
$155.12
2% above national avg
National Medicare Avg
$151.70
All states combined
Billed Charge (RI)
$617.58
What providers submit
Est. Commercial (RI)
$478.06
National avg: $428.43
Est. Cash / Self-Pay (RI)
$316.18
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

2.3K
Services in RI
27
Providers
N/A
Min Payment
N/A
Max Payment

Rhode Island Pricing in Context

In Rhode Island, CPT code 77427 (Radiation Treatment Management, 5 Treatment Sessions) carries an average Medicare payment of $155.12 — 2% above the national benchmark of $151.70. 27 providers across the state submitted claims for this procedure in 2023, performing 2.3K total services. Individual payments in RI ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Rhode Island is $617.58, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Rhode Island sits above the national Medicare average, commercial rates in the state may also run higher than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Imaging procedures, the estimated commercial insurance price in Rhode Island lands near $478.06, with self-pay cash prices typically around $316.18. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Radiation Treatment Management, 5 Treatment Sessions cost in Rhode Island?

The average Medicare payment for Radiation Treatment Management, 5 Treatment Sessions in Rhode Island is $155.12, which is 2% above the national average of $151.70. Providers in RI typically bill $617.58 for this procedure.

What does Radiation Treatment Management, 5 Treatment Sessions cost with insurance in Rhode Island?

With commercial insurance in Rhode Island, Radiation Treatment Management, 5 Treatment Sessions costs an estimated $478.06. Without insurance, the estimated cash price is $316.18. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Radiation Treatment Management, 5 Treatment Sessions in Rhode Island?

27 providers in Rhode Island billed Medicare for Radiation Treatment Management, 5 Treatment Sessions in 2023, performing 2.3K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Radiation Treatment Management, 5 Treatment Sessions cheaper in Rhode Island than the national average?

No — Radiation Treatment Management, 5 Treatment Sessions costs 2% above the national average in Rhode Island. The state average Medicare payment is $155.12 compared to $151.70 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial