Simple proton beam radiation treatment with compensation
Medicare pricing data for 29 providers across 3 states
This procedure has a 5.8x markup — hospitals charge $4,978 but Medicare allows only $859.76. Uninsured patients may face bills 5.8 times higher than what insurance negotiates. 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
Simple proton beam radiation treatment with compensation (HCPCS code 77522) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $859.76, but hospitals typically charge $4,978 — a 5.8x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $859.76, your out-of-pocket cost would be approximately $171.95. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $684.42 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $1,002 | $4,224 | 15 | 702 | +16.5% |
| Virginia | $854 | $4,757 | 3 | 5,035 | -0.7% |
| Illinois | $802 | $5,798 | 1 | 1,438 | -6.7% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber