A9584

Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries

Medicare pricing data for 374 providers across 33 states

🤖AI Overview

Prices vary significantly by location — from $945 in New Jersey to $4,047 in Minnesota. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries (HCPCS code A9584) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $2,600, but hospitals typically charge $5,049 — a 1.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$519.94

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $2,600, your out-of-pocket cost would be approximately $519.94. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$2,600
Average Hospital Charge
$5,049
Markup Ratio
1.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5,048.85
Medicare Allowed$2,599.72
Medicare Payment$2,070.16

Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $2,070 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Minnesota$4,047$5,2601498+55.7%
North Carolina$3,315$3,652473+27.5%
Pennsylvania$2,843$7,447842+9.4%
Iowa$2,769$5,047367+6.5%
Puerto Rico$2,769$2,904325+6.5%
California$2,762$5,224421,063+6.2%
Nevada$2,756$3,72822171+6.0%
Washington$2,748$5,9547121+5.7%
Arizona$2,744$9,37037877+5.6%
Georgia$2,744$3,9056149+5.5%
Indiana$2,725$5,500134+4.8%
Ohio$2,683$3,080482+3.2%
South Carolina$2,681$3,488125+3.1%
Missouri$2,681$3,750131+3.1%
Florida$2,627$4,372831,965+1.1%
Oregon$2,597$2,787524-0.1%
Arkansas$2,593$5,433250-0.3%
Virginia$2,573$5,8608301-1.0%
Maine$2,527$2,762114-2.8%
Wisconsin$2,514$9,149220-3.3%
Massachusetts$2,491$3,274538-4.2%
Connecticut$2,474$3,027345-4.9%
Maryland$2,450$2,73111361-5.8%
Colorado$2,432$4,631442-6.4%
Illinois$2,431$4,45316266-6.5%
New York$2,418$4,43822216-7.0%
Louisiana$2,409$5,9502155-7.3%
Nebraska$2,404$2,468125-7.5%
Texas$2,313$4,111391,011-11.0%
Kansas$2,276$3,000111-12.5%
Mississippi$2,266$4,086161-12.8%
New Mexico$1,820$5,194216-30.0%
New Jersey$945$3,842775-63.6%

⚠️ 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