78492

Nuclear medicine studies of blood flow in heart muscle at rest and with stress

Medicare pricing data for 1,401 providers across 36 states

🤖AI Overview

Prices vary significantly by location — from $80 in Arkansas to $1,636 in New Jersey. 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 (HCPCS code 78492) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,315, but hospitals typically charge $3,359 — a 2.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$263.06

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,315, your out-of-pocket cost would be approximately $263.06. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,315
Average Hospital Charge
$3,359
Markup Ratio
2.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$3,358.81
Medicare Allowed$1,315.31
Medicare Payment$1,045.47

Hospitals charge 2.6x more than what Medicare allows for this procedure. Medicare actually pays $1,045 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$1,636$2,715342,877+24.4%
Alaska$1,603$4,09210755+21.8%
Maryland$1,590$3,324414,409+20.9%
New York$1,539$3,279485,127+17.0%
Pennsylvania$1,501$2,751241,005+14.1%
North Carolina$1,491$1,9951992+13.3%
California$1,481$3,99917525,998+12.6%
Florida$1,440$3,2181478,167+9.5%
Washington$1,430$3,11315700+8.7%
Oregon$1,377$2,2007463+4.7%
Connecticut$1,371$2,5994179+4.2%
Louisiana$1,352$4,139745,891+2.8%
Massachusetts$1,351$3,534312+2.7%
Virginia$1,349$3,039421,603+2.5%
Wisconsin$1,321$7,04511583+0.5%
Mississippi$1,302$2,988332,461-1.0%
Oklahoma$1,271$4,8015889-3.3%
Arizona$1,258$2,791604,120-4.4%
Nevada$1,232$4,504402,735-6.3%
Georgia$1,225$4,8721023,561-6.9%
Illinois$1,222$3,142392,800-7.1%
Michigan$1,208$3,5658137-8.1%
Texas$1,164$2,91225716,861-11.5%
District of Columbia$1,155$2,3903143-12.2%
Delaware$984$1,600516-25.2%
Kansas$943$1,48321916-28.3%
Iowa$892$2,66791,109-32.2%
Kentucky$606$1,72914756-53.9%
Alabama$587$1,335492,632-55.4%
Missouri$554$1,30711644-57.9%
Ohio$194$69227515-85.2%
Tennessee$144$61639976-89.1%
Colorado$85$28017195-93.5%
Utah$84$264253-93.6%
Indiana$80$130411-93.9%
Arkansas$80$1,703117-94.0%

⚠️ 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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