78816

Nuclear medicine study whole body with ct scan

Medicare pricing data for 7,691 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $111 in West Virginia to $1,299 in Alaska. 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 whole body with ct scan (HCPCS code 78816) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $568.04, but hospitals typically charge $2,010 — a 3.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$113.61

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $568.04, your out-of-pocket cost would be approximately $113.61. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$568.04
Average Hospital Charge
$2,010
Markup Ratio
3.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,009.93
Medicare Allowed$568.04
Medicare Payment$450.05

Hospitals charge 3.5x more than what Medicare allows for this procedure. Medicare actually pays $450.05 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$1,299$5,18816267+128.7%
Nevada$1,123$3,17974615+97.6%
Puerto Rico$1,084$1,53217219+90.8%
Maryland$972$2,6151403,008+71.1%
New Jersey$899$2,8262042,272+58.3%
Florida$855$2,7354518,974+50.6%
Wyoming$853$1,6511774+50.2%
California$845$3,01069711,686+48.7%
Hawaii$836$2,06110200+47.2%
Alabama$782$1,849145991+37.7%
Arizona$763$2,1332222,551+34.3%
New York$762$3,2013808,676+34.1%
New Mexico$702$3,85648380+23.6%
Colorado$619$1,6171582,059+8.9%
Massachusetts$615$2,2201833,798+8.3%
Virginia$561$1,8801442,875-1.2%
Arkansas$546$1,758862,480-3.9%
Texas$540$1,92273310,011-4.9%
Idaho$510$1,78259551-10.2%
Washington$478$1,3301462,190-15.8%
Nebraska$451$1,27273926-20.6%
Kansas$442$1,2231011,209-22.2%
Oregon$440$1,352981,141-22.5%
Pennsylvania$440$1,6323013,711-22.5%
Maine$437$1,54251436-23.2%
Tennessee$403$1,6041501,775-29.0%
Indiana$391$1,3701681,477-31.2%
Illinois$383$1,5103683,655-32.5%
Louisiana$377$1,306116748-33.6%
South Dakota$357$98123334-37.2%
Wisconsin$349$2,2952161,772-38.5%
Oklahoma$332$1,124901,196-41.6%
Minnesota$309$1,4252452,739-45.5%
Rhode Island$299$1,09216310-47.4%
Ohio$297$1,1322152,566-47.6%
Connecticut$290$1,02678747-48.9%
District of Columbia$286$1,45810199-49.6%
Mississippi$283$1,18573824-50.1%
South Carolina$279$1,4071171,767-50.9%
Utah$269$77246314-52.7%
Kentucky$267$1,479104762-52.9%
Delaware$260$1,36121324-54.3%
Iowa$259$1,0541111,131-54.4%
North Dakota$247$66930257-56.6%
New Hampshire$235$1,25852583-58.6%
Georgia$219$1,0502102,208-61.5%
North Carolina$187$8302073,666-67.2%
Michigan$175$9201711,904-69.1%
Montana$171$57836223-69.9%
Missouri$170$6201801,883-70.0%
Vermont$111$56616261-80.4%
West Virginia$111$46060391-80.5%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber