How many shoppable procedure prices are published for The Miriam Hospital?

The Miriam Hospital in Providence, RI currently has 129 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do The Miriam Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, The Miriam Hospital's median negotiated commercial rate is 1.6× the regionally adjusted fair BaseRate benchmark.

What is The Miriam Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns The Miriam Hospital an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 247 Beds · urban Updated: 4/1/2026

The Miriam Hospital

164 Summit Avenue, Providence, RI 02906 · 129 Priced Procedures · 75% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

High Markup · Shop Alternatives

1.57×vs. Fair Market Price

Typical commercial prices here are +57% above the fair benchmark (1.57×) even after accounting for local nurse/doctor wages and patient complexity.

63/100 · Caution

63/100Self-Pay Cash Beats Insurance 15% of the Time

File Completeness51

Price Logic88

Peer Alignment71

Clean Billing87

Real Cash Discount8

High-Markup · Check Safety

3-Star CMS clinical quality rating paired with 1.57× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

The Miriam Hospital prices shoppable and inpatient services (1.9× to 1.8× Medicare, divergence 0.95×) in alignment with regional hospital peers (1.57× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#6 of 6 in RI · 83rd State Percentile#2,739 of 3,385 in U.S. · 80th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.37× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 15% of shoppable procedures (25/100 Cash Honesty)
4-Star CMS clinical rating with 75% patient recommendation (69/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (35.1% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.4× markup over Medicare rates
Commercial insurance median sits at 1.72× Fair BaseRate (1.9× Medicare), so insured patients should always compare the self-pay cash price before paying.
Specialty infusion drugs (J-codes) average 1.1× Medicare — verify per-unit billing on itemized statements
Unnegotiated chargemaster list prices average 5.5× Medicare (22¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.9× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.95× Divergence

1.8× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+6% Upper Tail

Q25 1.37× · Q50 1.72× · Q75 1.83×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.9× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.4× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.1× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

2.8× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

2.7× MedicareFair

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.1× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

15% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 69/100Fair

Procedure Prices at The Miriam Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 129 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$31,756	$30,775	1.0×
Total hip replacement CPT Code: `27130`	—	$20,351	$13,413	1.5×
Total knee replacement CPT Code: `27447`	—	$20,351	$13,523	1.5×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$19,309	$19,087	1.0×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$19,178	$19,432	1.0×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$17,575	$17,936	1.0×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$9,561	$6,109	1.6×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$8,071	$8,223	1.0×
Breast lump removal CPT Code: `19120`	—	$7,401	$3,875	unverified
Inguinal hernia repair CPT Code: `49505`	—	$6,717	$3,629	1.9×
Bunion correction surgery CPT Code: `28296`	—	$6,284	$3,446	1.8×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$6,109	$3,372	1.8×
C-section delivery (full package) CPT Code: `59510`	—	$5,726	$2,975	1.9×
Vaginal delivery (full package) CPT Code: `59400`	—	$5,164	$2,680	1.9×
Cataract surgery with lens implant CPT Code: `66984`	—	$4,628	$2,540	1.8×
Trauma team activation HCPCS Code: `G0390`	—	$2,740	$1,453	1.9×
Colonoscopy with biopsy CPT Code: `45380`	$3,671	$2,459	$1,256	2.0×
Sleep study (overnight, in lab) CPT Code: `95810`	—	$2,030	$1,021	2.0×
Colonoscopy (diagnostic) CPT Code: `45378`	$3,671	$1,911	$981	1.9×
Upper endoscopy with biopsy CPT Code: `43239`	$3,153	$1,864	$987	1.9×
Injection procedure for pain management HCPCS Code: `G0260`	—	$1,451	$855	1.7×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,261	$1,123	$583	unverified
Blood transfusion CPT Code: `36430`	$1,213	$907	$498	unverified
MRI, brain (with and without contrast) CPT Code: `70553`	$3,600	$717	$511	1.4×
Neurobehavioral status check CPT Code: `96116`	—	$609	$231	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,900	$542	$448	1.2×
Psychological testing by technician CPT Code: `96138`	—	$514	$395	1.3×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$610	$510	$272	unverified
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,835	$462	$303	1.5×
MRI, lower back (no contrast) CPT Code: `72148`	$2,300	$462	$338	1.4×
MRI, brain (no contrast) CPT Code: `70551`	$2,134	$468	$343	1.4×
MRI, knee or other leg joint CPT Code: `73721`	$2,100	$462	$369	1.3×
CT scan, head (with contrast) CPT Code: `70460`	$1,881	$361	$242	1.5×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,975	$361	$258	1.4×
Rabies immune globulin HCPCS Code: `90375`	$14,321	$347	$322	1.1×
Psychotherapy session (45 minutes) CPT Code: `90834`	$378	$257	$166	1.5×
Family therapy session CPT Code: `90847`	$400	$257	$173	1.5×
Psychiatric evaluation (first visit) CPT Code: `90791`	$358	$257	$185	unverified
Psychotherapy session (60 minutes) CPT Code: `90837`	$366	$257	$181	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$455	$230	$134	1.7×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$403	$241	$148	1.6×
Psychological testing evaluation CPT Code: `96136`	—	$248	$128	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$199	$199	$86	2.3×
X-ray, lower back CPT Code: `72110`	$302	$215	$112	1.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$454	$215	$126	1.7×
Ultrasound, pelvis CPT Code: `76856`	$340	$215	$130	1.7×
Ultrasound, thyroid and neck CPT Code: `76536`	$454	$215	$132	1.6×
CT scan, sinuses CPT Code: `70486`	$1,041	$226	$166	1.4×
Screening mammogram (both breasts) CPT Code: `77067`	$403	$199	$123	1.6×
CT scan, head (no contrast) CPT Code: `70450`	$1,100	$215	$160	1.3×
CT scan, pelvis CPT Code: `72192`	$1,230	$215	$163	1.3×
CT scan, chest (no contrast) CPT Code: `71250`	$1,230	$215	$167	1.3×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,230	$215	$168	1.3×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,230	$215	$169	1.3×
X-ray, pelvis CPT Code: `72170`	$261	$215	$110	unverified
Breathing treatment (nebulizer) CPT Code: `94640`	$219	$219	$201	unverified
X-ray, chest (single view) CPT Code: `71045`	$227	$176	$92	unverified
X-ray, chest (two views) CPT Code: `71046`	$238	$176	$93	unverified
X-ray, neck (cervical spine) CPT Code: `72040`	$227	$176	$93	unverified
X-ray, shoulder CPT Code: `73030`	$213	$176	$92	unverified
X-ray, hand CPT Code: `73130`	$213	$176	$93	unverified
X-ray, hip CPT Code: `73502`	$218	$176	$93	unverified
X-ray, ankle CPT Code: `73610`	$212	$176	$93	unverified
X-ray, foot CPT Code: `73630`	$213	$176	$92	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$324	$150	$86	1.7×
Office visit, established patient (30-39 min) CPT Code: `99214`	$365	$163	$123	1.3×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$235	$121	$64	1.9×
Group therapy session CPT Code: `90853`	$207	$145	$100	1.4×
Hepatitis B immune globulin HCPCS Code: `90371`	$426	$170	$151	1.1×
New patient office visit (30-44 min) CPT Code: `99203`	$299	$142	$110	1.3×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$87	$25	3.5×
Orthotic fitting and training CPT Code: `97760`	$132	$92	$51	1.8×
Office visit, established patient (20-29 min) CPT Code: `99213`	$302	$116	$87	1.3×
Prosthetic fitting and training CPT Code: `97761`	$134	$81	$45	1.8×
Behavioral health assessment HCPCS Code: `H0001`	—	$88	$157	0.6×
Behavioral health residential care HCPCS Code: `H0011`	—	$88	$364	0.2×
Typhoid vaccine HCPCS Code: `90675`	$1,293	$406	$347	1.2×
Drug screening test HCPCS Code: `G0480`	$271	$271	$116	unverified
Pneumococcal vaccine HCPCS Code: `90732`	$149	$133	$140	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$162	$153	$203	0.8×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$85	$85	$27	3.1×
Pneumonia vaccine injection HCPCS Code: `G0009`	$109	$96	$49	2.0×
Colorectal cancer screening HCPCS Code: `G0010`	$98	$96	$49	2.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$132	$71	$40	1.8×
Flu vaccine injection HCPCS Code: `G0008`	$109	$96	$48	unverified
Physical therapy (functional capacity test) CPT Code: `97750`	$153	$67	$38	1.8×
Blood test, vitamin D CPT Code: `82306`	$145	$54	$31	1.7×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$165	$65	$38	1.7×
Extended office visit (prolonged) HCPCS Code: `G2212`	$56	$56	$33	1.7×
Occupational therapy (self-care training) CPT Code: `97535`	$143	$64	$38	1.7×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$115	$35	$20	1.8×
Physical therapy (gait training) CPT Code: `97116`	$165	$54	$33	1.6×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$185	$57	$35	1.6×
Physical therapy (manual therapy) CPT Code: `97140`	$190	$54	$34	1.6×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$52	$35	1.5×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$146	$54	$111	0.5×
Blood antibody screen CPT Code: `86850`	$104	$77	$46	unverified
Speech therapy (group session) CPT Code: `92508`	$140	$48	$27	1.8×
Blood test, lipase CPT Code: `83690`	$53	$13	$7	1.9×
Blood test, clotting time (PTT) CPT Code: `85730`	$47	$11	$6	1.8×
Blood test, calcium CPT Code: `82310`	$35	$9	$5	1.8×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$62	$18	$10	1.8×
Blood test, PSA (prostate screen) CPT Code: `84153`	$115	$34	$19	1.8×
Blood test, ferritin (iron stores) CPT Code: `82728`	$92	$25	$14	1.8×
Culture, bacterial CPT Code: `87070`	$69	$16	$9	1.8×
Blood test, vitamin B12 CPT Code: `82607`	$119	$28	$16	1.8×
Blood test, glucose (blood sugar) CPT Code: `82947`	$27	$7	$4	1.8×
Blood test, complete blood count (CBC) CPT Code: `85025`	$52	$14	$8	1.8×
Hepatitis C antibody test CPT Code: `86803`	$100	$26	$15	1.7×
Blood test, comprehensive metabolic panel CPT Code: `80053`	—	$19	$11	1.7×
Culture, blood CPT Code: `87040`	$83	$19	$11	1.7×
Blood test, thyroid (TSH) CPT Code: `84443`	$107	$31	$18	1.7×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$109	$24	$14	1.7×
Blood test, amylase CPT Code: `82150`	$75	$12	$7	1.7×
Blood test, magnesium CPT Code: `83735`	$53	$12	$7	1.7×
Electrical stimulation therapy HCPCS Code: `G0283`	$187	$24	$14	1.7×
Blood test, basic metabolic panel CPT Code: `80048`	—	$15	$9	1.7×
Blood test, liver function panel CPT Code: `80076`	—	$15	$9	1.7×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$37	$8	$5	1.6×
Blood test, hemoglobin CPT Code: `85018`	$21	$4	$3	1.3×
Flu vaccine (high dose) HCPCS Code: `90656`	$38	$23	$25	0.9×
Hepatitis B vaccine HCPCS Code: `90744`	$78	$33	$37	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$59	$28	$56	0.5×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$17	$39	0.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$25	$6	$3	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$38	$9	$5	unverified
Blood test, potassium CPT Code: `84132`	$30	$9	$5	unverified
Blood test, sodium CPT Code: `84295`	$32	$9	$5	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$24	$7	$4	unverified

Showing top 25 high-impact procedures of 129 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 35.1%

Audit a Bill or Quote at The Miriam Hospital (Zero PHI Required)

CMS CCN: 410012

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $31,756

1. Amount on Your Bill or Quote ($) Pre-filled with The Miriam Hospital’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $26,759 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $26,759

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (35.1% of gross = $26,759).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask The Miriam Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$45,439 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($76,214) is $45,439 above the denoised Fair BaseRate ($30,775) and 3.2× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 050258905

Filing Period: 193501

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (35.1% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite69/100

Would Recommend75%

Rated 9 or 10 (HCAHPS)70%

Median ER Wait303 min

Left ER Before Seen5%

30-Day Mortality vs U.S.better

Unplanned Readmissionsame

Hip/Knee Complication Rate2.4%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionbetter

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at The Miriam Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-03-19·administrative_or_closure
Met Requirements
Recorded
2024-05-13·administrative_or_closure
Closure Notice
Recorded
2024-02-05·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (440 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Higher-Quality, Above-Median Price Tier Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for The Miriam Hospital.

Price Index: 1.24× regional baseline

Quality: 74/100 CMS composite

Median Household Income$78,204U.S. Census ACS

Local Uninsured Share5.3%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 63/100 · Caution CMS CCN 410012 EIN 050258905

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 410012) ↗ Verify IRS Form 990 (EIN 050258905) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage4/1/2026

Validated Rate Rows1,268 (CMS v3.0.0)

File Integrity DigestVerified · CCN 410012

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy