Diagnostic radiology · Rhode Island

Diagnostic radiology commercial reimbursement in Rhode Island

How Rhode Island diagnostic radiology rates compare with the national market.

Diagnostic radiology in Rhode Island

49 codes · 128 sampled providers
Index vs national
98
2% below
Rank among states
30 of 51
1 = highest
Codes above national
21 of 49
median code at 98%
Providers
128
sampled

What the data shows

1

Diagnostic radiology ranks 30th of 51 states in Rhode Island with an index of 98 (100 = the specialty's national median), across 49 codes and 128 sampled providers.

2

Of the 49 diagnostic radiology codes with enough data in Rhode Island, 21 pay above the national median and 28 below; the typical code sits at 98% of the national median.

3

Largest premium over the national median: CPT 71271 (Ct thorax lung cancer scr c-) at 113%; largest discount: CPT 77080 (Dxa bone density axial) at 84%.

4

Measured against Medicare, Rhode Island diagnostic radiology rates have a median of 148% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeRhode IslaNationalGapProv.
71271
Ct thorax lung cancer scr c-
$236$208+13%126
71260
Ct thorax dx c+
$342$312+10%126
72125
Ct neck spine w/o dye
$268$249+8%126
77049
Mri breast c-+ w/cad bi
$600$558+8%126
72131
Ct lumbar spine w/o dye
$266$248+7%126

Lowest vs national

CodeRhode IslaNationalGapProv.
77080
Dxa bone density axial
$56$66-16%126
37243
Vasc embolize/occlude organ
$727$858-15%125
93880
Extracranial bilat study
$235$277-15%126
93970
Extremity study
$241$270-11%126
99203
Office o/p new low 30 min
$108$121-11%128

All diagnostic radiology codes in Rhode Island

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeRhode IslandNationalGap% of MedicareProvidersTINsLevel
CPT 71271
Ct thorax lung cancer scr c-
$236$208+13%173%126262
CPT 71260
Ct thorax dx c+
$342$312+10%205%126221
CPT 72125
Ct neck spine w/o dye
$268$249+8%205%126220
CPT 77049
Mri breast c-+ w/cad bi
$600$558+8%177%126262
CPT 72131
Ct lumbar spine w/o dye
$266$248+7%205%126221
CPT 71250
Ct thorax dx c-
$268$250+7%202%126220
CPT 73221
Mri joint upr extrem w/o dye
$431$407+6%210%126221
CPT 73721
Mri jnt of lwr extre w/o dye
$430$407+6%210%126222
CPT 77066
Dx mammo incl cad bi
$234$225+4%149%127266
CPT 72141
Mri neck spine w/o dye
$404$390+4%212%126222
CPT 70450
Ct head/brain w/o dye
$201$194+4%189%126222
CPT 72148
Mri lumbar spine w/o dye
$405$392+3%211%126222
CPT 70551
Mri brain stem w/o dye
$416$402+3%213%126222
CPT 71275
Ct angiography chest
$476$462+3%170%127222
CPT 77067
Scr mammo bi incl cad
$187$182+3%148%126223
CPT 93000
Electrocardiogram complete
$26$25+2%166%126214
CPT 70496
Ct angiography head
$467$457+2%171%127222
CPT 77065
Dx mammo incl cad uni
$183$179+2%147%126223
CPT 70498
Ct angiography neck
$467$459+2%171%127221
CPT 72158
Mri lumbar spine w/o & w/dye
$600$593+1%188%126222
CPT 74174
Cta abd&plvs w/contrast
$607$601+1%160%126222
CPT 70553
Mri brain stem w/o & w/dye
$600$600+0%189%126222
CPT 74177
Ct abd & pelvis w/contrast
$446$448-1%148%127223
CPT 71045
X-ray exam chest 1 view
$33$33-1%128%126220
CPT 99213
Office o/p est low 20 min
$86$88-2%91%128258
CPT 73502
X-ray exam hip uni 2-3 views
$60$61-3%123%126224
CPT 20610
Drain/inj joint/bursa w/o us
$80$83-4%116%127266
CPT 74178
Ct abd&plv wo cntr flwd cntr
$499$520-4%148%126223
CPT 74183
Mri abd w/o cntr flwd cntr
$605$634-5%180%127223
CPT 72197
Mri pelvis w/o & w/dye
$603$634-5%180%127223
CPT 99214
Office o/p est mod 30 min
$122$128-5%90%128257
CPT 99215
Office o/p est hi 40 min
$171$182-6%89%128257
CPT 74176
Ct abd & pelvis w/o contrast
$270$287-6%148%126223
CPT 71046
X-ray exam chest 2 views
$42$45-6%127%127222
CPT 76700
Us exam abdom complete
$157$168-7%137%126221
CPT 99204
Office o/p new mod 45 min
$174$187-7%98%128258
CPT 76770
Us exam abdo back wall comp
$147$158-7%138%126221
CPT 76536
Us exam of head and neck
$143$154-8%132%126222
CPT 76641
Ultrasound breast complete
$134$145-8%134%125221
CPT 76705
Echo exam of abdomen
$116$126-8%135%126221
CPT 76642
Ultrasound breast limited
$110$120-8%132%127223
CPT 99212
Office o/p est sf 10 min
$46$50-8%78%128260
CPT 99205
Office o/p new hi 60 min
$221$244-10%93%128259
CPT 93971
Extremity study
$154$172-10%133%126263
CPT 99203
Office o/p new low 30 min
$108$121-11%92%128260
CPT 93970
Extremity study
$241$270-11%131%126263
CPT 93880
Extracranial bilat study
$235$277-15%124%126220
CPT 37243
Vasc embolize/occlude organ
$727$858-15%151%125251
CPT 77080
Dxa bone density axial
$56$66-16%141%126220

Frequently asked questions

How do Rhode Island diagnostic radiology rates compare with the rest of the country?

Rhode Island ranks 30th of 51 states with an index of 98; 21 of 49 codes are above the national median.

Which diagnostic radiology code has the biggest premium in Rhode Island?

CPT 71271 (Ct thorax lung cancer scr c-), at 113% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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