78264

Nuclear medicine study of stomach to assess emptying

Medicare pricing data for 8,342 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $35 in Oklahoma to $183 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 stomach to assess emptying (HCPCS code 78264) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $69.85, but hospitals typically charge $285.62 — a 4.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$13.97

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $69.85, your out-of-pocket cost would be approximately $13.97. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$69.85
Average Hospital Charge
$285.62
Markup Ratio
4.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$285.62
Medicare Allowed$69.85
Medicare Payment$54.05

Hospitals charge 4.1x more than what Medicare allows for this procedure. Medicare actually pays $54.05 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$183$3162065+162.3%
Nevada$167$57088356+138.6%
Maryland$158$4221551,235+126.4%
Arizona$136$558137977+94.8%
New Jersey$124$4492471,105+77.7%
Florida$106$4236124,395+52.3%
New York$98$3273562,299+41.0%
California$88$3516783,826+26.0%
Texas$87$3655353,716+25.2%
Connecticut$82$24899461+17.6%
Kansas$79$190125725+13.6%
New Mexico$76$30455310+9.0%
Wyoming$75$25728143+7.1%
Nebraska$70$24776390+0.1%
Washington$68$2461531,048-2.7%
Tennessee$65$2842511,602-6.6%
Oregon$62$217111491-11.7%
Massachusetts$60$2502151,330-14.1%
Delaware$58$24116186-16.8%
Illinois$58$2913541,815-16.8%
North Carolina$58$2373091,859-17.0%
Colorado$57$204125884-18.2%
Mississippi$53$314114871-23.8%
Kentucky$52$184144999-25.2%
Iowa$51$20094415-27.4%
Missouri$50$2011981,385-27.9%
Alaska$50$34725110-28.7%
Wisconsin$48$416183778-31.9%
Ohio$47$2682291,803-32.2%
Idaho$47$28667326-32.4%
Georgia$46$2272761,748-34.3%
Virginia$46$1561861,594-34.7%
Minnesota$46$188224842-34.7%
Pennsylvania$45$2323562,729-35.6%
South Carolina$43$2211661,067-38.6%
Arkansas$43$16696942-38.6%
Alabama$41$151180873-41.4%
District of Columbia$40$1811287-42.7%
Michigan$40$2021881,182-43.0%
Indiana$38$1771761,155-45.0%
Hawaii$37$3101764-46.5%
Rhode Island$37$14125209-46.8%
New Hampshire$37$22455222-46.9%
Montana$37$12039167-47.3%
Louisiana$37$1951801,153-47.7%
Vermont$36$2261575-47.9%
North Dakota$36$18226104-48.1%
Maine$36$16860181-48.5%
South Dakota$36$13322174-48.7%
Utah$36$21749210-48.8%
West Virginia$36$15976380-48.9%
Oklahoma$35$173104540-49.2%

⚠️ 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