South Dakota · 77427

Radiation Treatment Management, 5 Treatment Sessions in South Dakota

South Dakota Medicare Avg
$145.37
4% below national avg
National Medicare Avg
$151.70
All states combined
Billed Charge (SD)
$453.88
What providers submit
Est. Commercial (SD)
$377.32
National avg: $428.43
Est. Cash / Self-Pay (SD)
$262.86
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

3.9K
Services in SD
24
Providers
N/A
Min Payment
N/A
Max Payment

South Dakota Pricing in Context

In South Dakota, CPT code 77427 (Radiation Treatment Management, 5 Treatment Sessions) carries an average Medicare payment of $145.37 — 4% below the national benchmark of $151.70. 24 providers across the state submitted claims for this procedure in 2023, performing 3.9K total services. Individual payments in SD ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in South Dakota is $453.88, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because South Dakota sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Imaging procedures, the estimated commercial insurance price in South Dakota lands near $377.32, with self-pay cash prices typically around $262.86. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Radiation Treatment Management, 5 Treatment Sessions cost in South Dakota?

The average Medicare payment for Radiation Treatment Management, 5 Treatment Sessions in South Dakota is $145.37, which is 4% below the national average of $151.70. Providers in SD typically bill $453.88 for this procedure.

What does Radiation Treatment Management, 5 Treatment Sessions cost with insurance in South Dakota?

With commercial insurance in South Dakota, Radiation Treatment Management, 5 Treatment Sessions costs an estimated $377.32. Without insurance, the estimated cash price is $262.86. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Radiation Treatment Management, 5 Treatment Sessions in South Dakota?

24 providers in South Dakota billed Medicare for Radiation Treatment Management, 5 Treatment Sessions in 2023, performing 3.9K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Radiation Treatment Management, 5 Treatment Sessions cheaper in South Dakota than the national average?

Yes — Radiation Treatment Management, 5 Treatment Sessions costs 4% below the national average in South Dakota. The state average Medicare payment is $145.37 compared to $151.70 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial