55876

Placement of device in prostate for radiation therapy

Medicare pricing data for 3,241 providers across 50 states

🤖AI Overview

Prices vary significantly by location — from $51 in South Dakota to $273 in Maryland. 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

Placement of device in prostate for radiation therapy (HCPCS code 55876) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $128.69, but hospitals typically charge $641.17 — a 5.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$25.74

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $128.69, your out-of-pocket cost would be approximately $25.74. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$128.69
Average Hospital Charge
$641.17
Markup Ratio
5.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$641.17
Medicare Allowed$128.69
Medicare Payment$101.19

Hospitals charge 5.0x more than what Medicare allows for this procedure. Medicare actually pays $101.19 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$273$79282672+111.9%
Utah$225$1,00026213+75.1%
Virginia$200$78580971+55.1%
Mississippi$199$53324155+54.6%
Nebraska$197$74545271+53.2%
Pennsylvania$188$6131551,144+46.4%
Kentucky$166$44251331+28.7%
Tennessee$158$64261675+22.9%
Florida$151$7992882,055+17.1%
Washington$131$53284571+2.1%
North Carolina$131$650134695+2.0%
Nevada$130$58227243+1.1%
Hawaii$129$488564+0.4%
Texas$126$7991491,292-2.4%
New Mexico$125$415314-2.8%
California$125$7672491,845-2.9%
Oregon$122$50933155-5.3%
New York$121$7642151,949-6.1%
Massachusetts$120$506132800-6.5%
Alaska$117$1,1631276-9.4%
Missouri$116$53392643-9.8%
Arizona$116$663108846-10.0%
New Jersey$113$730129717-12.2%
Georgia$112$54580457-13.3%
Illinois$105$649106900-18.2%
Rhode Island$103$29722123-19.7%
Oklahoma$103$46852345-19.8%
South Carolina$103$44475504-20.0%
Colorado$103$46654433-20.2%
Alabama$103$39543189-20.3%
Idaho$102$353964-20.6%
District of Columbia$97$52012159-24.9%
Louisiana$87$36048273-32.2%
Vermont$86$610421-33.1%
Wisconsin$86$83854330-33.5%
Indiana$85$59461318-33.9%
Arkansas$80$41234243-37.7%
Delaware$79$71619182-39.0%
Ohio$75$42186532-42.0%
New Hampshire$72$7241163-44.2%
Kansas$65$30535435-49.2%
Minnesota$65$44441368-49.7%
Montana$64$26918103-50.3%
Michigan$63$39655386-51.1%
North Dakota$61$49511132-52.3%
Connecticut$61$51353242-52.8%
Maine$60$372515-53.2%
West Virginia$60$2841464-53.4%
Iowa$51$39120112-60.1%
South Dakota$51$3361581-60.1%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber