Rhode Island · 96417

Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in Rhode Island

Rhode Island Medicare Avg
$52.59
4% above national avg
National Medicare Avg
$50.77
All states combined
Billed Charge (RI)
$224.00
What providers submit
Est. Commercial (RI)
$161.70
National avg: $137.32
Est. Cash / Self-Pay (RI)
$111.10
Typical self-pay discount

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

26
Services in RI
2
Providers
N/A
Min Payment
N/A
Max Payment

Rhode Island Pricing in Context

In Rhode Island, CPT code 96417 (Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less) carries an average Medicare payment of $52.59 — 4% above the national benchmark of $50.77. 2 providers across the state submitted claims for this procedure in 2023, performing 26 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 $224.00, 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 Medicine procedures, the estimated commercial insurance price in Rhode Island lands near $161.70, with self-pay cash prices typically around $111.10. 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 Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cost in Rhode Island?

The average Medicare payment for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in Rhode Island is $52.59, which is 4% above the national average of $50.77. Providers in RI typically bill $224.00 for this procedure.

What does Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cost with insurance in Rhode Island?

With commercial insurance in Rhode Island, Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs an estimated $161.70. Without insurance, the estimated cash price is $111.10. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in Rhode Island?

2 providers in Rhode Island billed Medicare for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in 2023, performing 26 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cheaper in Rhode Island than the national average?

No — Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs 4% above the national average in Rhode Island. The state average Medicare payment is $52.59 compared to $50.77 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