78451

Nuclear medicine study of heart muscle at rest and with stress and spect

Medicare pricing data for 3,985 providers across 48 states

🤖AI Overview

Prices vary significantly by location — from $60 in Arkansas to $219 in Nevada. 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 study of heart muscle at rest and with stress and spect (HCPCS code 78451) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $124.59, but hospitals typically charge $447.61 — a 3.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$24.92

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $124.59, your out-of-pocket cost would be approximately $24.92. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$124.59
Average Hospital Charge
$447.61
Markup Ratio
3.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$447.61
Medicare Allowed$124.59
Medicare Payment$95.43

Hospitals charge 3.6x more than what Medicare allows for this procedure. Medicare actually pays $95.43 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Nevada$219$82924156+75.9%
Texas$203$8812441,835+62.8%
Utah$181$5701072+45.3%
California$171$4564213,676+37.5%
New Jersey$159$57895237+27.7%
Tennessee$155$48481207+24.2%
Alabama$147$436912,369+18.0%
Virginia$129$324154933+3.1%
North Carolina$127$453135301+2.0%
Arizona$126$49477301+1.1%
Florida$126$375308826+1.0%
South Carolina$124$62971194-0.5%
Connecticut$124$52690327-0.5%
New York$122$5742371,099-2.3%
Maryland$112$283921,288-10.2%
Kansas$112$35954281-10.5%
Pennsylvania$97$468193430-22.4%
Wisconsin$94$91192251-24.7%
Georgia$88$332129363-29.3%
Louisiana$88$3714484-29.4%
Kentucky$85$25158161-31.9%
Massachusetts$80$3011422,038-35.9%
Ohio$77$236123524-37.8%
Minnesota$77$31472100-38.3%
Illinois$77$388205744-38.6%
Michigan$76$506115592-38.8%
Washington$76$27890214-39.2%
Colorado$73$18148338-41.7%
District of Columbia$69$342956-44.9%
Hawaii$65$323820-47.8%
Iowa$64$45750281-48.4%
Delaware$64$383621-48.5%
New Hampshire$64$32726232-48.9%
Montana$64$1591246-48.9%
New Mexico$63$187912-49.2%
Wyoming$63$6962101-49.6%
Vermont$63$628721-49.7%
Maine$63$2182442-49.7%
Oregon$62$2572567-49.9%
South Dakota$62$2451241-50.0%
Missouri$62$33964665-50.1%
Oklahoma$62$2022363-50.2%
Idaho$61$1351114-50.8%
Indiana$61$36263216-50.8%
Nebraska$61$1922538-50.9%
Mississippi$61$355819-51.1%
West Virginia$60$4071928-51.9%
Arkansas$60$21716158-51.9%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber