@jeffmarc Mayo may be doing fine with Proton but about 25% of Proton centers are in default on their bonds. Emory University put in a bankruptcy auction bid to buy the Proton center that they staff but did not build or own for 20c on the $. No other bids so far. Mayo may Price proton competitive to photon, but costs are higher. The Medicare reimbursement is over twice the rate for proton vs IMRT photon. Other than buying at a discount in bankruptcy (that is one way to lower costs), it will probably take 10 to 20 years for the costs to even get close.