77290

Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved

Medicare pricing data for 6,907 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $81 in Vermont to $445 in Puerto Rico. Where you get this procedure matters more than almost any other factor. 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, 3 or more treatment areas or any number of treatment areas where special treatment is involved (HCPCS code 77290) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $207.22, but hospitals typically charge $768.25 — a 3.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$41.44

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $207.22, your out-of-pocket cost would be approximately $41.44. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$207.22
Average Hospital Charge
$768.25
Markup Ratio
3.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$768.25
Medicare Allowed$207.22
Medicare Payment$163.93

Hospitals charge 3.7x more than what Medicare allows for this procedure. Medicare actually pays $163.93 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$445$5331670+114.7%
Arizona$360$8711635,794+73.7%
Florida$330$99262017,687+59.3%
California$292$1,04263617,683+40.8%
Alabama$274$8281042,529+32.1%
Texas$270$1,0854469,241+30.1%
Nevada$262$846431,178+26.3%
North Dakota$254$1,10218425+22.7%
Rhode Island$246$1,32126426+18.9%
Maryland$221$8001303,981+6.6%
Louisiana$218$849941,952+5.1%
Arkansas$211$955521,291+2.0%
Hawaii$211$78022515+1.6%
Minnesota$204$1,1961511,830-1.5%
Alaska$203$3,15418358-1.9%
Washington$203$6061994,126-2.1%
New Jersey$201$5511495,680-3.0%
Georgia$196$6422114,500-5.6%
Nebraska$194$716471,193-6.4%
New Mexico$186$62027375-10.2%
Utah$184$816521,236-11.3%
Oklahoma$180$639582,460-13.0%
Wyoming$175$1,0226284-15.4%
Kentucky$169$534932,317-18.3%
Tennessee$167$4631454,700-19.4%
New York$165$6944518,104-20.1%
South Carolina$163$578982,530-21.2%
Oregon$163$6321011,479-21.3%
Virginia$163$5731274,143-21.3%
Indiana$160$6021443,602-22.6%
Delaware$157$921241,084-24.5%
Illinois$155$8572786,175-25.3%
North Carolina$150$6172204,601-27.6%
Montana$148$63926695-28.7%
Idaho$144$44234901-30.6%
Colorado$144$4201312,031-30.7%
New Hampshire$141$62032980-31.9%
West Virginia$140$69825749-32.3%
Kansas$136$502451,487-34.2%
Pennsylvania$130$5133517,703-37.3%
Michigan$128$6251984,186-38.2%
Ohio$121$4943184,869-41.8%
Mississippi$120$479471,370-42.2%
Massachusetts$117$5652014,522-43.4%
Connecticut$117$690891,815-43.6%
Missouri$111$4481333,301-46.3%
Wisconsin$109$1,5941672,375-47.6%
Maine$106$31332822-49.0%
District of Columbia$100$40723668-51.6%
Iowa$95$428541,454-54.2%
South Dakota$85$27020635-59.0%
Vermont$81$45511348-61.1%

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

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