Cost analysis for CPT A9595 — Piflufolastat f-18, diagnostic, 1 millicurie
Average Medicare Payment
$587.28
2023 data
Total Payments (2023)
$94.4M
Services (2023)
189.5K
Price Change (2022–2023)
-33.6%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2022 | $884.32 | $62.9M | 102.7K | — |
| 2023 | $587.28 | $94.4M | 189.5K | -33.6% |
The most expensive state pays 1.8x more than the cheapest for this procedure. NM averages $704.25 vs GA at $387.19.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| NM | $704.25 | $1.2M | 1.8K | 4 |
| TX | $644.76 | $5.7M | 8.8K | 38 |
| NJ | $602.33 | $3.0M | 5.0K | 19 |
| AR | $571.66 | $727.1K | 1.3K | 8 |
| MS | $544.20 | $177.4K | 326 | 2 |
| VA | $543.66 | $3.9M | 7.2K | 12 |
| LA | $537.64 | $529.0K | 984 | 5 |
| CO | $537.36 | $3.1M | 5.8K | 22 |
| MD | $514.79 | $6.3M | 12.2K | 37 |
| OK | $500.37 | $575.4K | 1.1K | 3 |
| MA | $493.22 | $5.4M | 11.0K | 21 |
| UT | $489.33 | $167.4K | 342 | 1 |
| SD | $489.33 | $128.2K | 262 | 2 |
| DC | $489.33 | $88.6K | 181 | 1 |
| OR | $489.28 | $413.4K | 845 | 5 |
| MO | $487.77 | $158.0K | 324 | 3 |
| MN | $486.27 | $1.1M | 2.2K | 8 |
| RI | $485.35 | $206.3K | 425 | 1 |
| CA | $485.19 | $18.0M | 37.1K | 87 |
| NV | $485.17 | $548.2K | 1.1K | 5 |
| WI | $484.35 | $740.6K | 1.5K | 7 |
| MI | $484.34 | $145.3K | 300 | 1 |
| AZ | $484.30 | $4.6M | 9.5K | 25 |
| WA | $484.29 | $2.1M | 4.3K | 14 |
| KS | $484.11 | $1.5M | 3.0K | 5 |
| CT | $483.92 | $348.4K | 720 | 1 |
| IL | $481.61 | $2.9M | 6.1K | 22 |
| KY | $480.99 | $50.5K | 105 | 1 |
| NH | $479.19 | $426.5K | 890 | 1 |
| ME | $478.98 | $250.0K | 522 | 2 |
| NC | $477.87 | $1.4M | 2.9K | 11 |
| PA | $477.80 | $2.3M | 4.8K | 22 |
| DE | $476.33 | $69.5K | 146 | 1 |
| NY | $470.03 | $11.8M | 25.1K | 47 |
| TN | $468.37 | $1.7M | 3.6K | 5 |
| MT | $464.78 | $108.8K | 234 | 1 |
| AL | $464.17 | $952.0K | 2.1K | 4 |
| SC | $462.77 | $1.8M | 3.8K | 10 |
| FL | $460.36 | $7.9M | 17.2K | 44 |
| IN | $454.21 | $676.3K | 1.5K | 5 |
| OH | $442.51 | $925.3K | 2.1K | 11 |
| GA | $387.19 | $257.5K | 665 | 3 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Tony Abraham | Diagnostic Radiology | NY | $2.8M | 5.8K | $483.63 |
| Ashley Blurton | Nuclear Medicine | VA | $2.0M | 4.4K | $464.48 |
| Aron Gould-Simon | Nuclear Medicine | CA | $1.1M | 2.4K | $482.92 |
| Center For Molecular Imaging Limited Partnership | Independent Diagnostic Testing Facility (IDTF) | TX | $952.4K | 257 | $3705.95 |
| Pejman Dalaie | Nuclear Medicine | NY | $934.4K | 1.9K | $480.39 |
| Ron Rosen | Nuclear Medicine | NY | $918.0K | 2.0K | $466.72 |
| East Tennessee Diagnostic Center, Llc | Independent Diagnostic Testing Facility (IDTF) | TN | $892.7K | 1.9K | $466.41 |
| Shields Imaging Of Eastern Massachusetts Llc | Independent Diagnostic Testing Facility (IDTF) | MA | $822.3K | 1.7K | $483.40 |
| John Mccormick | Diagnostic Radiology | NJ | $812.3K | 1.7K | $468.45 |
| E Plus Pet Imaging Xviii Lp | Independent Diagnostic Testing Facility (IDTF) | CO | $790.5K | 1.1K | $706.43 |
| Esther Coronel | Nuclear Medicine | NY | $779.0K | 1.6K | $486.24 |
| Dalia Artal | Diagnostic Radiology | CA | $756.6K | 1.5K | $488.78 |
| Philip Newlin | Pediatric Medicine | KS | $700.2K | 1.5K | $480.87 |
| Sherif Heiba | Nuclear Medicine | NY | $699.4K | 1.5K | $470.63 |
| Frederic Yeganeh | Diagnostic Radiology | MD | $689.4K | 1.2K | $564.63 |
| Ethan Spiegler | Nuclear Medicine | MD | $678.1K | 1.2K | $548.62 |
| Barry Charnick | Diagnostic Radiology | FL | $658.8K | 1.4K | $469.20 |
| Aaron Kistler | Nuclear Medicine | VA | $642.4K | 1.1K | $603.16 |
| Patrick Gonzales | Diagnostic Radiology | CA | $639.0K | 1.3K | $488.92 |
| David Carlson | Nuclear Medicine | CA | $635.7K | 1.3K | $489.35 |
Based on the data, CPT A9595 shows a 1.8x variation in pricing across states — moderate variation by Medicare standards.
Costs have decreased 33.6% since 2022. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
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.