0394T

High dose rate electronic brachytherapy, external

Medicare pricing data for 156 providers across 14 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

High dose rate electronic brachytherapy, external (HCPCS code 0394T) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $184.45, but hospitals typically charge $609.02 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$36.89

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $184.45, your out-of-pocket cost would be approximately $36.89. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$184.45
Average Hospital Charge
$609.02
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$609.02
Medicare Allowed$184.45
Medicare Payment$147.07

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $147.07 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Pennsylvania$257$1,71622,160+39.2%
Florida$240$310134,215+30.3%
Texas$222$677225,144+20.2%
Louisiana$222$6082308+20.2%
Michigan$219$533299+18.9%
Missouri$208$4001510+13.0%
Oregon$168$33411,777-9.2%
Nevada$166$3962479-10.0%
Georgia$166$2501143-10.1%
California$165$5937122,602-10.8%
Washington$164$512132,385-11.1%
Arizona$159$52071,925-13.6%
Illinois$159$926264-13.7%
Idaho$153$4801132-17.1%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber