Nuclear medicine study of lung circulation
Medicare pricing data for 7,040 providers across 50 states
This procedure has a 5.4x markup — hospitals charge $194.08 but Medicare allows only $36.17. Uninsured patients may face bills 5.4 times higher than what insurance negotiates. Prices vary significantly by location — from $33 in Arkansas to $85 in Puerto Rico. 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 lung circulation (HCPCS code 78580) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $36.17, but hospitals typically charge $194.08 — a 5.4x 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 $36.17, your out-of-pocket cost would be approximately $7.23. 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 5.4x more than what Medicare allows for this procedure. Medicare actually pays $27.89 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Puerto Rico | $85 | $98 | 3 | 11 | +133.7% |
| New Mexico | $55 | $227 | 41 | 229 | +50.7% |
| Massachusetts | $40 | $144 | 163 | 686 | +11.5% |
| Maryland | $40 | $129 | 166 | 1,951 | +10.8% |
| Ohio | $39 | $210 | 181 | 907 | +6.8% |
| New Jersey | $38 | $223 | 272 | 1,903 | +5.9% |
| District of Columbia | $38 | $155 | 16 | 114 | +4.6% |
| California | $37 | $199 | 471 | 2,486 | +3.2% |
| Florida | $37 | $235 | 589 | 3,969 | +1.2% |
| New York | $37 | $187 | 205 | 1,036 | +1.1% |
| Texas | $37 | $237 | 631 | 4,025 | +1.1% |
| Alaska | $37 | $138 | 4 | 16 | +1.0% |
| Tennessee | $36 | $188 | 204 | 984 | 0.0% |
| Washington | $36 | $166 | 61 | 235 | -0.5% |
| Vermont | $36 | $184 | 5 | 15 | -0.8% |
| Rhode Island | $36 | $132 | 20 | 162 | -1.1% |
| North Carolina | $36 | $180 | 243 | 1,132 | -1.7% |
| Illinois | $35 | $198 | 456 | 3,736 | -2.0% |
| Connecticut | $35 | $173 | 55 | 277 | -2.1% |
| Hawaii | $35 | $474 | 7 | 16 | -2.8% |
| Pennsylvania | $35 | $161 | 277 | 1,844 | -3.3% |
| Montana | $35 | $176 | 9 | 40 | -3.6% |
| Delaware | $35 | $204 | 25 | 350 | -3.6% |
| New Hampshire | $35 | $157 | 45 | 146 | -3.7% |
| Colorado | $35 | $232 | 104 | 424 | -4.0% |
| Nevada | $35 | $221 | 54 | 278 | -4.0% |
| Virginia | $35 | $149 | 238 | 2,204 | -4.3% |
| Michigan | $35 | $179 | 192 | 938 | -4.3% |
| Minnesota | $35 | $163 | 195 | 671 | -4.6% |
| Maine | $34 | $145 | 13 | 20 | -4.8% |
| Georgia | $34 | $175 | 323 | 1,753 | -5.4% |
| Wyoming | $34 | $75 | 10 | 27 | -5.8% |
| Missouri | $34 | $151 | 171 | 976 | -6.2% |
| Arizona | $34 | $338 | 131 | 1,011 | -6.2% |
| Utah | $34 | $186 | 66 | 243 | -6.8% |
| Oregon | $34 | $164 | 51 | 121 | -7.0% |
| Louisiana | $34 | $230 | 106 | 661 | -7.0% |
| South Carolina | $34 | $180 | 119 | 315 | -7.1% |
| Idaho | $34 | $156 | 25 | 43 | -7.1% |
| Oklahoma | $34 | $170 | 54 | 170 | -7.3% |
| Kansas | $34 | $110 | 93 | 471 | -7.3% |
| Iowa | $33 | $166 | 84 | 344 | -7.4% |
| Wisconsin | $33 | $277 | 122 | 323 | -7.6% |
| Alabama | $33 | $119 | 143 | 632 | -7.7% |
| Indiana | $33 | $167 | 187 | 1,042 | -7.8% |
| West Virginia | $33 | $178 | 58 | 144 | -7.9% |
| Kentucky | $33 | $145 | 103 | 483 | -8.1% |
| Mississippi | $33 | $153 | 73 | 312 | -8.8% |
| Nebraska | $33 | $173 | 47 | 148 | -9.6% |
| Arkansas | $33 | $152 | 72 | 398 | -9.8% |
⚠️ 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