78582

Nuclear medicine study of lung ventilation and circulation

Medicare pricing data for 8,877 providers across 52 states

🤖AI Overview

This procedure has a 5.2x markup — hospitals charge $285.16 but Medicare allows only $54.60. Uninsured patients may face bills 5.2 times higher than what insurance negotiates. 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 ventilation and circulation (HCPCS code 78582) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $54.60, but hospitals typically charge $285.16 — a 5.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.92

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $54.60, your out-of-pocket cost would be approximately $10.92. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$54.60
Average Hospital Charge
$285.16
Markup Ratio
5.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$285.16
Medicare Allowed$54.60
Medicare Payment$42.41

Hospitals charge 5.2x more than what Medicare allows for this procedure. Medicare actually pays $42.41 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Arizona$86$6391331,029+56.6%
Oregon$75$25265238+37.6%
Maryland$69$2171572,255+27.0%
Alaska$65$4662168+19.1%
Nevada$62$535114683+14.4%
Washington$61$250138870+12.2%
Florida$61$3317125,433+10.9%
Massachusetts$59$2212011,165+7.8%
California$58$2867815,746+6.3%
New Jersey$57$2552141,523+4.6%
North Carolina$56$2973722,279+2.6%
Iowa$56$21272287+2.5%
Mississippi$56$26594518+2.0%
New York$55$3113462,859+0.8%
District of Columbia$53$16619496-2.5%
Illinois$52$3223932,696-4.9%
Connecticut$52$204105707-5.1%
Texas$51$3476033,321-6.5%
Georgia$51$2943691,670-7.0%
Ohio$51$2892652,135-7.3%
Hawaii$51$2652045-7.4%
Michigan$50$2592471,282-7.8%
Colorado$50$2471771,034-8.8%
Delaware$50$25522506-8.9%
Pennsylvania$50$3122931,713-9.0%
Montana$49$17732108-9.5%
Rhode Island$49$16218138-9.5%
Wisconsin$49$4972371,105-9.8%
North Dakota$49$21030105-10.1%
New Mexico$49$21147369-10.2%
Wyoming$49$2821016-10.2%
Minnesota$49$228288970-10.3%
Maine$49$2003995-10.3%
New Hampshire$49$35540151-10.5%
Tennessee$49$2512761,893-10.5%
Virginia$49$1862111,083-10.7%
South Dakota$49$17520155-11.0%
Vermont$49$2561657-11.1%
Missouri$48$1962181,576-11.6%
Puerto Rico$48$110915-11.7%
Utah$48$18855142-12.0%
Idaho$48$41650169-12.1%
Kansas$48$17579321-12.1%
Kentucky$48$200144786-12.1%
Louisiana$48$267158831-12.4%
West Virginia$48$22989464-12.5%
Oklahoma$48$245139580-12.5%
Indiana$48$232149928-12.5%
South Carolina$48$2322091,298-12.5%
Nebraska$48$15451271-12.6%
Alabama$48$1221981,166-12.7%
Arkansas$47$25286682-13.8%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber