Medical Supplies · A9606 Drug

Radium Ra-223 Dichloride, Therapeutic, Per Microcurie

Medicare Payment (avg)
$128.44
What Medicare actually pays
Billed Charge (avg)
$328.24
What providers submit
Markup
2.6x
156% above Medicare rate
164.3K
Total Services
370
Beneficiaries
215
Providers
12
States with Data

Price Range Across States

Lowest State Avg
$120.18
California
Highest State Avg
$133.65
New York

What You Might Pay

Est. Commercial Insurance
$361.13
Range: $252.79 – $505.58
Est. Cash / Self-Pay
$211.18
Typical self-pay discount

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

How we estimate these prices

These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Medical Supplies procedures average 2.24x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.

Prices by State

State Medicare Payment Billed Charge
New York $133.65 $318.35
Tennessee $133.22 $289.55
Texas $131.56 $376.07
Maryland $131.55 $347.46
Pennsylvania $131.52 $257.67
Illinois $131.31 $291.12
New Jersey $129.30 $237.08
Nebraska $127.81 $306.99
Florida $126.64 $372.30
Washington $126.33 $335.37
Nevada $122.65 $293.40
California $120.18 $328.05

What the Data Says About Radium Ra-223 Dichloride, Therapeutic, Per Microcurie

Across 12 states with reporting providers, CPT code A9606 (Radium Ra-223 Dichloride, Therapeutic, Per Microcurie) shows a national average Medicare payment of $128.44 against an average billed charge of $328.24. That gap — a 2.6x markup, or 156% above the Medicare allowed amount — reflects chargemaster pricing, not what most insured patients actually pay. Medicare's negotiated rate is the statutory benchmark; commercial insurers typically settle between the two figures based on network contracts.

Medical Supplies procedures like this one saw 164.3K services billed to Medicare in 2023 by 215 distinct providers, serving 370 unique beneficiaries. State-level variation is significant: California reports the lowest average payment at $120.18, while New York reports the highest at $133.65. Geographic Practice Cost Indices (GPCIs) explain much of that spread — local malpractice premiums, practice expense, and physician work adjustments all shift the allowed amount even when the procedure is identical.

Applying RAND 2024 commercial-to-Medicare ratios specific to the Medical Supplies category (2.24x), the estimated commercial insurance price lands near $361.13, with self-pay cash discounts commonly bringing the figure closer to $211.18. Uninsured patients facing the full billed charge have the strongest leverage to negotiate — the Hospital Price Transparency Rule (effective January 2021) requires providers to publish standard charges, cash rates, and payer-specific negotiated prices. This data is for educational reference; confirm coverage and out-of-pocket exposure with your insurer before any procedure.

Frequently Asked Questions

How much does Radium Ra-223 Dichloride, Therapeutic, Per Microcurie cost?

The national average Medicare payment for Radium Ra-223 Dichloride, Therapeutic, Per Microcurie (CPT A9606) is $128.44, while providers typically bill $328.24. Prices vary significantly by state, ranging from $120.18 to $133.65.

Why do providers charge more than Medicare pays?

Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.

How much does Radium Ra-223 Dichloride, Therapeutic, Per Microcurie cost with insurance?

With commercial insurance, Radium Ra-223 Dichloride, Therapeutic, Per Microcurie costs an estimated $361.13 on average (range: $252.79 – $505.58). Without insurance, the estimated cash price is $211.18. These estimates are based on RAND 2024 research on commercial-to-Medicare price ratios. Your actual cost depends on your insurer, plan, and provider.

Which state has the lowest cost for Radium Ra-223 Dichloride, Therapeutic, Per Microcurie?

California has the lowest average Medicare payment for Radium Ra-223 Dichloride, Therapeutic, Per Microcurie at $120.18, while New York has the highest at $133.65. This $13.47 difference reflects geographic variation in healthcare costs, local cost of living, and provider market dynamics.

How many providers perform Radium Ra-223 Dichloride, Therapeutic, Per Microcurie?

Nationally, 215 providers billed Medicare for Radium Ra-223 Dichloride, Therapeutic, Per Microcurie in 2023, performing 164.3K total services for 370 beneficiaries across 12 states and territories.

What is the billed-to-Medicare markup for Radium Ra-223 Dichloride, Therapeutic, Per Microcurie?

Providers bill 2.6x what Medicare pays for Radium Ra-223 Dichloride, Therapeutic, Per Microcurie — a 156% markup. This gap between billed charges and actual payment is common across healthcare. Uninsured patients may face charges closer to the billed amount, while insured patients pay negotiated rates between the Medicare and billed figures.

Related

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