Billed Charges & Cash Rates

NCPIC Standard Charges (Chargemaster)

Billed PET/CT Charge

Billed Charges

Discounted Cash Rates

Medical Codes (CPT)

PET/CT - F-18

$3,789

78815

PET/CT - Physician Fee

$300

PET/CT - Radiopharmaceutical

$600

A9552

Total Billed Charges

$4,689

$2,100

SPECIALITY EXAMS

Billed Charges

Discounted Cash Rates

Medical Codes (CPT)

PET/CT  PSMA

$10,969

$7,028

78815, A9595

PET/CT  Axumin

$11,485

$7,062

78815, A9588

PET/CT  NET
(dotatate)

$9,883

$5,100

78815, A9587

PET/CT  Breast ER+

$10,093

$6,568

78815, A9591

PET/CT  Brain - Metabolic
(FDG)

$3,600

$1,500

78608, A9552

PET/CT  Brain – Amyloid

$7,807

$4,547

78814, A9586

NCPIC prices are considered global billed charges includes facility fee, physician fee and radiopharmaceutical

**please call if you do not see what you are looking for

Hospital Standard Charges (for pricing reference)

Billed PET/CT Charge (Range)

LOW             

HIGH

Medical Codes (CPT)

PET/CT - F-18 FDG

$6,852

$17,653

78815

PET/CT - Physician Fee

unknown

$3,723

PET/CT - Radiopharmaceutical

$520

$938

A9552