Payers shown: Blue Cross & Blue Shield of Rhode Island
Prices shown: surgery centers and hospital outpatient departments
Doctor’s fee or facility fee? These are doctors' (professional) fees only. If this is done in a hospital or surgery center, the facility bills its own fee on top — for the room, nurses and equipment — often larger than the doctor's. That fee is not included here. (About 4% of these prices are facility fees instead, which can show up as unusually high prices.) Where a state has both, the table and each state’s popup show the doctor’s fee and the facility fee side by side; their sum is a rough total for the visit, before anything else done during it.
Who is counted: Blue Cross & Blue Shield of Rhode Island lists clinicians individually: 89% of the 15,754 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs. Blue Cross & Blue Shield of Rhode Island’s files name 15,488 providers for this procedure; 1,179 are counted here: the clinicians whose specialty performs it — mostly Physician Assistant, Clinic/Center and Orthopaedic Surgery — and the practices, clinics and hospitals. Insurers attach their whole fee schedule to every contracted provider, so the rest are clinicians listed at a price for something they never do; counting them would inflate the provider count and pull the typical price towards the fee schedule’s floor.
Not on this map: These prices come from the file set every Blue plan publishes centrally for members of other Blue plans (BlueCard). It may leave out networks the plan publishes only on its own site. Hospital stays: Blue Cross & Blue Shield of Rhode Island's files have no prices for whole hospital stays (the kind billed as one amount per stay), so there are no hospital-stay maps for it. It may pay hospitals by the day or as a share of their charges, which these maps cannot show.
State
Providers
Named in files
Organisations
Zip codes
Lowest
25th pct
Median
75th pct
Highest
Doctor’s fee
Facility fee
vs Medicare
“x Medicare” compares each price with what original Medicare pays a doctor for the same service in the same state under its physician fee schedule (RVU26D, in force from 2026-10-01) — the lower price a doctor is paid when a hospital or surgery center provides the room and equipment. Insurers write their contracts as a share of Medicare, so 1.3x means the insurer pays 30% more than Medicare would; Medicare Advantage plans generally pay close to 1.0x.
This is a statewide summary. Prices vary far more between towns and between practices than these medians suggest; zip-code and provider-level detail is not published here; this specific data can be requested here.