Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan
Medicare pricing data for 2,066 providers across 45 states
Prices vary significantly by location — from $83 in Indiana to $2,464 in Florida. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan (HCPCS code 78431) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,507, but hospitals typically charge $3,963 — a 2.6x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,507, your out-of-pocket cost would be approximately $301.47. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.6x more than what Medicare allows for this procedure. Medicare actually pays $1,200 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $2,464 | $4,452 | 206 | 12,573 | +63.4% |
| Alabama | $2,330 | $3,388 | 53 | 4,235 | +54.6% |
| New Jersey | $2,281 | $4,033 | 36 | 3,793 | +51.3% |
| Delaware | $2,260 | $3,493 | 7 | 1,696 | +49.9% |
| Virginia | $2,189 | $5,133 | 64 | 3,045 | +45.2% |
| Texas | $2,024 | $5,050 | 213 | 19,419 | +34.3% |
| Pennsylvania | $1,871 | $5,224 | 148 | 8,164 | +24.1% |
| California | $1,820 | $3,655 | 145 | 15,574 | +20.7% |
| Louisiana | $1,721 | $3,915 | 50 | 2,976 | +14.2% |
| Illinois | $1,645 | $8,127 | 76 | 17,486 | +9.1% |
| Mississippi | $1,513 | $4,577 | 58 | 3,159 | +0.4% |
| Washington | $1,500 | $4,173 | 19 | 553 | -0.5% |
| Maryland | $1,354 | $1,823 | 16 | 487 | -10.2% |
| Nevada | $1,296 | $3,573 | 71 | 3,668 | -14.0% |
| New York | $1,217 | $3,910 | 87 | 7,501 | -19.3% |
| Arizona | $1,046 | $2,501 | 48 | 3,270 | -30.6% |
| Kansas | $871 | $1,559 | 36 | 1,776 | -42.3% |
| Connecticut | $494 | $1,662 | 48 | 771 | -67.2% |
| Tennessee | $462 | $851 | 41 | 664 | -69.3% |
| Kentucky | $454 | $1,016 | 42 | 990 | -69.9% |
| Arkansas | $443 | $930 | 37 | 3,170 | -70.6% |
| Massachusetts | $330 | $1,445 | 25 | 1,569 | -78.1% |
| Utah | $282 | $802 | 47 | 3,582 | -81.3% |
| Maine | $213 | $833 | 21 | 409 | -85.9% |
| Minnesota | $187 | $571 | 72 | 790 | -87.6% |
| North Carolina | $130 | $381 | 34 | 984 | -91.3% |
| Ohio | $130 | $331 | 49 | 1,701 | -91.4% |
| Michigan | $111 | $397 | 27 | 1,484 | -92.7% |
| Wisconsin | $101 | $474 | 34 | 546 | -93.3% |
| District of Columbia | $89 | $316 | 3 | 23 | -94.1% |
| New Hampshire | $87 | $358 | 7 | 398 | -94.2% |
| Colorado | $87 | $286 | 23 | 613 | -94.2% |
| North Dakota | $87 | $265 | 6 | 643 | -94.3% |
| South Dakota | $86 | $237 | 7 | 636 | -94.3% |
| New Mexico | $86 | $607 | 4 | 45 | -94.3% |
| Vermont | $86 | $420 | 5 | 302 | -94.3% |
| Missouri | $85 | $246 | 35 | 3,547 | -94.3% |
| West Virginia | $85 | $297 | 6 | 14 | -94.3% |
| Idaho | $85 | $178 | 1 | 38 | -94.3% |
| Georgia | $85 | $293 | 81 | 2,191 | -94.3% |
| Nebraska | $84 | $207 | 17 | 687 | -94.4% |
| Oklahoma | $84 | $238 | 23 | 1,391 | -94.4% |
| Iowa | $84 | $452 | 9 | 179 | -94.5% |
| Oregon | $84 | $247 | 2 | 329 | -94.5% |
| Indiana | $83 | $242 | 23 | 785 | -94.5% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber