HCPCS G0563 at Providence St Mary Medical Center

Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions

Providence St Mary Medical Center, Walla Walla

Description from CMS's HCPCS Level II code file.

What Providence St Mary Medical Center publishes for this code: as an outpatient

Providence St Mary Medical Center’s prices for HCPCS G0563, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$3,488 – $21,7777 plans	—
Medicare AdvantageInsurer rates	$3,545 – $3,9006 plans	—
Cash pricePaying yourself, without insurance	—	—
List priceBefore any discount; few people pay it	—	—

Lowest and highest amounts Providence St Mary Medical Center lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-04-01. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for HCPCS G0563 at Providence St Mary Medical Center
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The service	—	The price above

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare HCPCS G0563 at every Washington hospital, with Medicare’s reference amounts.