Cataract Surgery Cost in Rhode Island (2026): Average Prices & What You'll Pay
What does a cataract surgery cost in Rhode Island?
Where you have a cataract surgery done in Rhode Island swings the bill from $927 to $1,129 for identical care. The median cash price across 5 reporting hospitals is $989. The numbers are pulled directly from federally mandated hospital price transparency files. The sections below break this down by coverage and by insurer.
Three low-priced facilities in Rhode Island, from hospital price files
- Prospect CharterCare RWMC, LLC · Providence, RI $912
- The Miriam Hospital · Providence, RI $989
- Prospect CharterCare SJHSRI, LLC · North Providence, RI $1,164
All 5 facilities are listed below, free.
Where cataract surgery costs vary in Rhode Island
Pins show hospitals with price-transparency data (colored by vs. state average) and nearby ambulatory surgery centers and other facilities (colored by type). Click any pin for facility name and estimated cost range.
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Insurance covers cataract surgery - but the premium lens it won't cover can add $1,500–$3,000 per eye.
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Cheapest Cataract Surgery Providers in Rhode Island
Based on declared cash/self-pay prices from CMS hospital price transparency files.
| # | Facility | City | Price | vs Median |
|---|---|---|---|---|
| 1 | Prospect CharterCare RWMC, LLC | Providence, RI | $912 | -$77 |
| 2 | The Miriam Hospital | Providence, RI | $989 | +$0 |
| 3 | Prospect CharterCare SJHSRI, LLC | North Providence, RI | $1,164 | +$175 |
| 4 | Rhode Island Hospital | Providence, RI | $2,432 | +$1,443 |
Prices are declared self-pay rates. Contact each facility for a formal quote before scheduling.
Before you book: three questions that change the price
- Is this the self-pay price, and does it include the doctor, anesthesia and any lab or pathology? Those are often billed separately.
- Can you give me the price in writing, with the billing codes it covers?
- What happens to the price if something extra is needed during the procedure?
Estimate your out-of-pocket cost → · When the bills arrive, we check them for errors →
Quick take
- Prospect CharterCare RWMC, LLC is the lowest-cost option at $912 - $77 below the state median, just by choosing where you go.
- Ask for the cash price if your deductible isn't met - the median cash price here is $989, and it's often lower than what insurance pays before your deductible is satisfied.
- Freestanding ambulatory surgical centers (ASCs) are often 30-60% cheaper than hospital outpatient departments for the same procedure and may not appear in this hospital-only dataset - ask your doctor if one is an option.
| Coverage | Hospitals with a rate | Typical range | Median |
|---|---|---|---|
| Medicare (national rate) | — | $2,358 to $4,223 | $2,358 |
| With insurance (commercial, average) | 3 | $6,251 to $6,649 | $6,426 |
| Without insurance (cash price) | 5 | $848 to $1,925 | $989 |
| Blue Cross & Blue Shield of Rhode Island | 3 | $4,569 to $4,806 | $4,745 |
| UnitedHealthcare | 3 | $1,756 to $8,051 | $4,822 |
| Cigna | 3 | $10,985 to $13,918 | $11,297 |
Rates are negotiated allowed amounts and cash prices from hospital price-transparency files (October 2026), shown at each hospital’s lowest-priced typical billing code for this procedure. Facility fees only. The typical range is the middle 80% of hospitals, not a quote for your visit.
How much does a cataract surgery cost with Medicare in Rhode Island?
Medicare's national hospital outpatient payment for cataract surgery is about $2,358 to $4,223 (typically near $2,358). After the $257 Part B deductible, you generally pay 20% of the Medicare-approved amount, about $472 on a $2,358 payment, with no out-of-pocket cap unless you have supplemental coverage or a Medicare Advantage plan.
Doctor, anesthesia and pathology fees are billed separately. Medicare rates are national CMS amounts, adjusted slightly by local wage levels.
How much does a cataract surgery cost with insurance in Rhode Island?
Across 3 Rhode Island hospitals, the negotiated rates commercial insurers pay for cataract surgery average $6,251 to $6,649 per hospital, with a median near $6,426. That is the amount your plan and you pay the hospital together; you owe your deductible, then coinsurance, up to your out-of-pocket maximum.
Each hospital’s figure is the average of the commercial insurers it lists. Medicare, Medicare Advantage and Medicaid rates are excluded.
How much does a cataract surgery cost without insurance in Rhode Island?
Cash (self-pay) prices for cataract surgery at 5 Rhode Island hospitals range from $848 to $1,925, with a median of $989. Ask for the cash or self-pay price and for any financial-assistance discount before you book; both can be lower than the posted price.
Cash prices are the hospital’s published discounted rate for patients paying without insurance.
How much does a cataract surgery cost with Blue Cross & Blue Shield of Rhode Island?
Blue Cross & Blue Shield of Rhode Island negotiated rates for cataract surgery at 3 Rhode Island hospitals range from $4,569 to $4,806, with a median near $4,745. Your own cost depends on your plan’s deductible and coinsurance, and on whether the hospital is in your network.
Includes Blue Cross and Blue Shield and Anthem plans listed by each hospital.
How much does a cataract surgery cost with UnitedHealthcare in Rhode Island?
UnitedHealthcare negotiated rates for cataract surgery at 3 Rhode Island hospitals range from $1,756 to $8,051, with a median near $4,822. If a hospital is out of network for your UnitedHealthcare plan, you may owe more than the negotiated rate, so check the network first.
How much does a cataract surgery cost with Cigna in Rhode Island?
Cigna negotiated rates for cataract surgery at 3 Rhode Island hospitals range from $10,985 to $13,918, with a median near $11,297. If a hospital is out of network for your Cigna plan, you may owe more than the negotiated rate, so check the network first.
How where you go changes what you pay for cataract surgery
The same cataract surgery bundles different services depending on the setting - facility fee, surgeon fee, and anesthesia each arrive as separate bills. Estimated ranges below reflect the typical full bundled cost, including all expected charges.
- Facility fee $805–$2,432
- Professional fee $803–$2,932
Estimated from CMS fee schedules + commercial rate multipliers
Lifespan (Rhode Island Hospital, Miriam Hospital) and Care New England (Women & Infants, Kent Hospital) dominate a market that is effectively a single metro area - Providence and its immediate suburbs. Rhode Island approved a merger between the two systems, which when complete will create a near-monopoly in the state's hospital market. Prices here already trend above the Northeast average. Medicare covers cataract surgery at a defined allowed amount wage-adjusted for your location - the main cost variable isn't geography but lens type. Standard monofocal lenses are fully covered; premium multifocal or toric lenses add $1,500–$3,000 per eye out-of-pocket regardless of insurance. Ambulatory surgery centers consistently charge less than hospital outpatient departments for the identical procedure.
Received a bill? Check it for errors → Estimate YOUR cost before you go → Managing more than one bill? See the family tracker →
Why prices vary - and what it means for your coverage
A small number of hospitals (1) report prices above $1,542, including Rhode Island Hospital at $2,432, which drives most of the overall spread - excluding them, most facilities cluster in a much tighter band. Facility classification matters as much as the hospital itself - a hospital-owned outpatient center adds a facility fee that a freestanding clinic does not. Setting drives most of the spread here: an ambulatory surgical center (ASC) is usually meaningfully cheaper than a hospital operating room for the same procedure, when your case qualifies.
What you pay out of pocket on top of this depends on your deductible, your plan's out-of-pocket maximum, and whether every provider involved is in-network - not just the facility.
| Your situation | Estimated out-of-pocket |
|---|---|
| Deductible not yet met | ~$989 |
| Deductible met - 20% coinsurance | ~$198 |
| Out-of-network provider | $2,176+ |
Frequently asked questions: cataract surgery costs in Rhode Island
How much does a cataract surgery cost in Rhode Island?
The typical insurer-negotiated rate is $989, with most facilities between $912 and $1,129 (based on 5 hospitals reporting negotiated rates). Full market pricing - including cash rates, gross charges, and outlier facilities - ranges more widely, from $805 to $20,234 across all 5 Rhode Island hospitals that publish prices. What you pay depends on the facility, your insurance, and whether you have met your deductible.
Where is the cheapest place to get a cataract surgery in Rhode Island?
Based on declared prices, the lowest-cost facility in our Rhode Island data is Newport Hospital in Newport at about $805. By metro, Providence has the lowest median ($989). Freestanding ambulatory surgery centers are often cheaper still and may not appear in hospital price data - ask your doctor whether one is an option.
Why is a cataract surgery so much cheaper at some Rhode Island hospitals?
Prices vary up to 25.1× because each hospital sets its own list price, cash discount, and insurer-negotiated rates. In Rhode Island, the median cash (self-pay) price is $989 versus a median negotiated rate of $6,426 - cash is the lower number at many hospitals. Asking for the cash price as well as your insurer's negotiated rate is often the single biggest lever on what you pay.
How much will I actually pay out of pocket for a cataract surgery in Rhode Island?
Your out-of-pocket cost depends on your deductible, coinsurance, out-of-pocket maximum, and whether the facility is in-network - not just the sticker price. If you have not met your deductible, you will typically pay the negotiated rate in full until you do. Use the CostKits cost forecaster to estimate your specific out-of-pocket amount before you go.
Before you book
- Allowed amount vs negotiated rate: what your EOB is really saying
- How to read your medical bill
- Deductible vs out-of-pocket max
- Already have a bill? Check it for errors
- How to read a Medicare Summary Notice
Other procedures in Rhode Island
Cataract Surgery, elsewhere
What matters before you schedule
ASC vs. hospital
Hospital outpatient departments typically charge 2-4x more than ambulatory surgery centers for the same cataract surgery - same outcome, very different bill. Call ahead and ask for a self-pay or cash quote at each setting you're considering.
What's on your bill
A cataract surgery involves multiple providers who bill separately - typically Facility Fee, Surgeon Professional Fee, Anesthesia. Check each line item against your Explanation of Benefits to catch billing errors.
Cost by type
Which type your doctor orders for this cataract surgery changes the billing code, and what you pay. For example: A recognized variation that can change the billing code and what you owe.
What to ask before you book
Get the CPT code from your doctor, confirm every provider involved (not just the facility) is in-network, ask for the cash-pay rate if you're uninsured or haven't met your deductible, and request a written estimate for cataract surgery before you schedule.
CostKits compiles hospital price transparency data to help families make informed decisions. Track and manage your healthcare costs (free account).
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About the Author
John Caruso, FSA, MAAA
Healthcare actuary with 20+ years of experience in insurance pricing, medical billing systems, and healthcare cost analytics.
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