77331

Special radiation therapy planning

Medicare pricing data for 1,830 providers across 47 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

Special radiation therapy planning (HCPCS code 77331) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $51.61, but hospitals typically charge $189.75 — a 3.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.32

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $51.61, your out-of-pocket cost would be approximately $10.32. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$51.61
Average Hospital Charge
$189.75
Markup Ratio
3.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$189.75
Medicare Allowed$51.61
Medicare Payment$40.99

Hospitals charge 3.7x more than what Medicare allows for this procedure. Medicare actually pays $40.99 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$65$553292+25.6%
Rhode Island$62$220333+20.0%
Alaska$61$719330+18.8%
Florida$61$2111602,625+18.8%
Arizona$61$13448635+18.1%
Nevada$60$273864+16.5%
Alabama$59$129263,554+15.2%
Maryland$56$18343431+8.6%
Arkansas$55$24310162+6.5%
Oklahoma$54$20720426+4.6%
Louisiana$53$21029591+3.2%
Indiana$53$22633165+2.7%
California$52$2891822,809+1.5%
Texas$52$23169342+1.1%
Minnesota$52$2341695+0.3%
New York$52$2451501,660+0.2%
West Virginia$52$2261262-0.1%
Kansas$51$20916180-1.5%
New Mexico$51$204749-1.9%
New Jersey$51$12744838-2.0%
District of Columbia$50$1631074-3.0%
Georgia$50$19866489-3.7%
Washington$49$20975968-4.2%
Kentucky$49$17928150-5.0%
Tennessee$49$193341,192-5.6%
North Carolina$49$23459415-5.7%
Pennsylvania$48$1861071,362-6.5%
Massachusetts$48$26251422-6.8%
South Carolina$48$27732343-7.2%
Connecticut$47$17523149-8.4%
Oregon$47$146963-8.4%
Illinois$47$26472675-9.2%
Colorado$47$15530215-9.6%
Virginia$46$114454,541-10.8%
Delaware$46$255779-11.0%
Ohio$46$14182483-11.2%
Wisconsin$46$40748199-11.5%
Utah$45$150816-13.0%
Idaho$45$342421-13.3%
Nebraska$45$21020248-13.4%
Vermont$45$248624-13.4%
Missouri$45$1532381-13.8%
South Dakota$45$121729-13.8%
Montana$44$113421-14.1%
Iowa$44$1701073-14.9%
Mississippi$43$16112408-17.3%
Michigan$43$151411,069-17.6%

⚠️ 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