Virginia · 77427

Radiation Treatment Management, 5 Treatment Sessions in Virginia

Virginia Medicare Avg
$151.61
0% below national avg
National Medicare Avg
$151.70
All states combined
Billed Charge (VA)
$725.17
What providers submit
Est. Commercial (VA)
$420.98
National avg: $428.43
Est. Cash / Self-Pay (VA)
$342.94
Typical self-pay discount

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

24.8K
Services in VA
133
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Virginia

Provider Medicare Services
Sinesi, Christopher M.D. $148.88 916
Flax, Bruce M.D. $150.21 836
Sinesi, Mathew M.D. $147.93 673
Buck, David M.D. $147.16 637
Thornton, Allan M.D. $149.03 597
Adams, Bret MD, PHD $148.54 573
Randolph, David M.D. $148.41 522
Crimaldi, Anthony M.D. $148.73 501
Crandley, Edwin MD $151.42 500
Aggarwal, Sanjeev MD $148.35 498

Virginia Pricing in Context

In Virginia, CPT code 77427 (Radiation Treatment Management, 5 Treatment Sessions) carries an average Medicare payment of $151.61 — 0% below the national benchmark of $151.70. 133 providers across the state submitted claims for this procedure in 2023, performing 24.8K total services. Individual payments in VA 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 Virginia is $725.17, 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 Virginia 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 Virginia lands near $420.98, with self-pay cash prices typically around $342.94. 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 Virginia?

The average Medicare payment for Radiation Treatment Management, 5 Treatment Sessions in Virginia is $151.61, which is 0% below the national average of $151.70. Providers in VA typically bill $725.17 for this procedure.

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

With commercial insurance in Virginia, Radiation Treatment Management, 5 Treatment Sessions costs an estimated $420.98. Without insurance, the estimated cash price is $342.94. 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 Virginia?

133 providers in Virginia billed Medicare for Radiation Treatment Management, 5 Treatment Sessions in 2023, performing 24.8K total services. Medicare payments ranged from N/A to N/A depending on the provider.

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

Yes — Radiation Treatment Management, 5 Treatment Sessions costs 0% below the national average in Virginia. The state average Medicare payment is $151.61 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