Cost analysis for CPT 78431 — Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan
Average Medicare Payment
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Total Payments (Latest)
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Services (Latest)
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Price Change (–)
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The most expensive state pays 33.0x more than the cheapest for this procedure. FL averages $1971.02 vs WI at $59.71.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| FL | $1971.02 | $24.2M | 12.3K | 138 |
| AL | $1859.92 | $7.8M | 4.2K | 47 |
| NJ | $1826.56 | $6.9M | 3.8K | 31 |
| DE | $1806.00 | $3.1M | 1.7K | 7 |
| VA | $1764.90 | $5.3M | 3.0K | 54 |
| TX | $1617.18 | $31.0M | 19.2K | 159 |
| PA | $1519.34 | $12.1M | 8.0K | 98 |
| CA | $1450.79 | $22.3M | 15.4K | 100 |
| LA | $1370.48 | $4.0M | 2.9K | 25 |
| IL | $1306.30 | $22.8M | 17.4K | 56 |
| WA | $1229.74 | $656.7K | 534 | 14 |
| MS | $1220.04 | $3.8M | 3.1K | 44 |
| MD | $1171.09 | $511.8K | 437 | 4 |
| NV | $1044.99 | $3.7M | 3.5K | 42 |
| NY | $971.58 | $7.2M | 7.4K | 70 |
| AZ | $841.47 | $2.7M | 3.2K | 33 |
| KS | $680.10 | $1.2M | 1.7K | 26 |
| KY | $378.97 | $346.4K | 914 | 23 |
| AR | $350.16 | $1.1M | 3.1K | 16 |
| TN | $341.08 | $190.0K | 557 | 17 |
| CT | $305.02 | $205.3K | 673 | 27 |
| MA | $260.73 | $408.0K | 1.6K | 21 |
| UT | $220.18 | $785.4K | 3.6K | 35 |
| ME | $175.28 | $66.3K | 378 | 14 |
| MN | $112.23 | $65.3K | 582 | 25 |
| NC | $88.11 | $82.5K | 936 | 24 |
| MI | $84.78 | $121.4K | 1.4K | 17 |
| OH | $79.96 | $129.9K | 1.6K | 30 |
| NH | $67.99 | $26.7K | 393 | 5 |
| SD | $65.73 | $41.6K | 633 | 6 |
| IN | $65.38 | $48.9K | 748 | 12 |
| GA | $65.07 | $135.8K | 2.1K | 54 |
| CO | $64.72 | $38.6K | 596 | 19 |
| MO | $64.40 | $225.3K | 3.5K | 22 |
| ND | $64.34 | $41.4K | 643 | 6 |
| OR | $64.01 | $21.1K | 329 | 2 |
| VT | $63.75 | $19.3K | 302 | 5 |
| OK | $63.19 | $86.6K | 1.4K | 16 |
| IA | $61.83 | $10.9K | 177 | 7 |
| NE | $59.98 | $40.9K | 682 | 13 |
| WI | $59.71 | $26.8K | 449 | 10 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Cardiac Imaging Inc | Independent Diagnostic Testing Facility (IDTF) | IL | $16.6M | 10.2K | $1626.19 |
| Modern Nuclear, Inc. | Independent Diagnostic Testing Facility (IDTF) | CA | $8.0M | 4.9K | $1651.16 |
| Victor Gabrielian | Cardiology | CA | $2.7M | 1.5K | $1727.49 |
| Armita Atashband | Interventional Cardiology | TX | $1.5M | 756 | $1958.05 |
| Rajiv Agarwal | Cardiology | TX | $1.4M | 719 | $1958.99 |
| Barry Shapiro | Cardiology | NJ | $1.4M | 619 | $2185.91 |
| Russell Fileccia | Cardiology | LA | $1.3M | 796 | $1671.70 |
| Gaetano Pastore | Cardiology | DE | $1.3M | 650 | $1968.09 |
| Ryan Houk | Cardiology | FL | $1.3M | 579 | $2165.15 |
| Harvey Snyder | Cardiology | NJ | $1.2M | 531 | $2181.44 |
| Anthony Furey | Cardiology | DE | $1.1M | 537 | $1957.96 |
| Doral Imaging Institute Llc | Independent Diagnostic Testing Facility (IDTF) | FL | $1.0M | 447 | $2279.77 |
| Stanley Duchman | Interventional Cardiology | TX | $1.0M | 519 | $1948.89 |
| Stefano Sdringola-Maranga | Interventional Cardiology | TX | $995.8K | 507 | $1964.02 |
| Karan Bhalla | Cardiology | TX | $929.3K | 474 | $1960.50 |
| Alberto Lopez | Clinical Cardiac Electrophysiology | TX | $924.2K | 479 | $1929.41 |
| Edward Rutkovsky | Cardiology | NY | $901.1K | 562 | $1603.46 |
| Sergio Sokol | Cardiology | NY | $898.5K | 561 | $1601.52 |
| Evann Eisenberg | Cardiology | CA | $887.8K | 515 | $1723.89 |
| Ronald Levine | Cardiology | FL | $860.3K | 388 | $2217.28 |
The data suggests significant pricing inconsistencies for CPT 78431. With a 33.0x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have remained relatively stable over time, but the geographic variation suggests Medicare's geographic adjustment factors may not fully capture the true cost differences across states.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.