77285

Obtaining data needed to develop the optimal radiation treatment, 2 treatment areas

Medicare pricing data for 357 providers across 33 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Obtaining data needed to develop the optimal radiation treatment, 2 treatment areas (HCPCS code 77285) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $424.14, but hospitals typically charge $780.04 — a 1.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$84.83

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $424.14, your out-of-pocket cost would be approximately $84.83. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$424.14
Average Hospital Charge
$780.04
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$780.04
Medicare Allowed$424.14
Medicare Payment$336.85

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $336.85 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$531$1,255352+25.1%
California$524$69438846+23.6%
Washington$500$1,042659+18.0%
New Jersey$490$753414+15.5%
Connecticut$484$838319+14.1%
Delaware$452$451228+6.5%
Pennsylvania$447$811433+5.3%
Minnesota$446$924748+5.1%
Montana$445$822315+4.9%
Georgia$426$1,00415201+0.4%
South Dakota$422$1,050231-0.6%
Illinois$421$1,01924155-0.8%
Texas$420$90431631-0.9%
Michigan$417$8911444-1.7%
Utah$415$996640-2.1%
Oregon$413$951318-2.7%
Wisconsin$410$2,430219-3.3%
Florida$407$705351,942-4.1%
North Carolina$407$82424120-4.1%
South Carolina$405$6838106-4.5%
Indiana$404$65820901-4.8%
Iowa$402$1,287380-5.1%
Louisiana$394$1,3581578-7.2%
Oklahoma$394$80610339-7.2%
Ohio$388$748518-8.6%
Alabama$386$706885-8.9%
Mississippi$385$710444-9.3%
Tennessee$385$64214157-9.3%
Arkansas$385$662213-9.3%
Missouri$384$6831185-9.4%
Kentucky$371$729319-12.5%
Arizona$366$73012126-13.7%
Virginia$343$1,169516-19.2%

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

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