Complex proton beam radiation treatment
Medicare pricing data for 96 providers across 9 states
This procedure has a 6.3x markup — hospitals charge $7,322 but Medicare allows only $1,161. Uninsured patients may face bills 6.3 times higher than what insurance negotiates. 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
Complex proton beam radiation treatment (HCPCS code 77525) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,161, but hospitals typically charge $7,322 — a 6.3x 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 $1,161, your out-of-pocket cost would be approximately $232.29. 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 6.3x more than what Medicare allows for this procedure. Medicare actually pays $924.98 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New Jersey | $1,352 | $16,849 | 5 | 1,209 | +16.4% |
| California | $1,291 | $6,362 | 9 | 3,724 | +11.2% |
| Maryland | $1,249 | $5,245 | 10 | 80 | +7.5% |
| Oklahoma | $1,238 | $6,000 | 4 | 151 | +6.6% |
| Pennsylvania | $1,181 | $12,030 | 4 | 32 | +1.7% |
| Florida | $1,173 | $5,804 | 18 | 1,816 | +1.0% |
| Texas | $1,151 | $7,660 | 3 | 2,041 | -0.9% |
| Illinois | $997 | $6,606 | 2 | 1,548 | -14.1% |
| Virginia | $989 | $5,790 | 3 | 2,698 | -14.9% |
⚠️ 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