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See a sample rate comparisonCPT 78434 Fee Schedule
Medicare rates as of October 2026
CPT 78434 is classified under Radiology Procedures, in the Nuclear Medicine Procedures subgroup.
Absolute Quantitation Of Myoca, Absolute Quantitation Of Myocardial Blood Flow (Aqmbf) Positron Emission Tomography (Pet) Rest Andpharmacologic Stress (List Separately In Addition To Code For Primary Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $28.73 national non-facility rate (2026) · View Medicare rates for 78434 |
| Medicaid Fee Schedule | $125.94 median of the 7 states in the free preview · View Medicaid rates for 78434 |
National average reimbursement for CPT 78434 by major payers:
$183.63
BCBS / Anthem
$94.51
UnitedHealthcare
$1,289.89
Aetna
$282.60
Cigna
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CPT 78434
5 of 25 sample ratesHigher to lower in this preview
James Mcaleer
Poudre Valley Medical Group LLC
$196.96Published rateJoan Siracuse
Sebring Heart Center, P.A.
$111.44Published rateChristopher Watts
$40.11Published rateDany El-Hajjar
Pioneer Medical Group, Pl
$25.28Published rateAlexander Kushnir
General Conference Of Seventh Day Adventist
$21.35Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78434 vs. Other Nuclear Medicine Procedures Codes
The table lists codes related to 78434. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 78432-CPT | High | Myocrd Img Pet 2rtracer, Myocardial Imaging Positron Emission Tomography Pet Combined Perfusion With Metabolic Evaluation Study Including Ventricular Wall Motion S And Or Ejection Fraction S When Performed Dual Radiotracer Eg Myocardial Viability |
| 78433-CPT | High | Myocrd Img Pet 2rtracer Ct, Myocardial Imaging Positron Emission Tomography Pet Combined Perfusion With Metabolic Evaluation Study Including Ventricular Wall Motion S And Or Ejection Fraction S When Performed Dual Radiotracer Eg Myocardial Viability With Concurrently Acquired Computed Tomography Transmission Scan |
| 78434-CPT | Low | Absolute Quantitation Of Myoca, Absolute Quantitation Of Myocardial Blood Flow (Aqmbf) Positron Emission Tomography (Pet) Rest Andpharmacologic Stress (List Separately In Addition To Code For Primary Procedure) |
| 78451-CPT | Moderate | Ht Muscle Image Spect Sing, Myocardial Perfusion Imaging Tomographic Spect Including Attenuation Correction Qualitative Or Quantitative Wall Motion Ejection Fraction By First Pass Or Gated Technique Additional Quantification When Performed Single Study At Rest Or Stress Exercise Or Pharmacologic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78434. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78434 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
To find the cost of a specific medical procedure based on a CPT code and your location, you can use online tools. For a precise estimate, consider using Payerprice, which offers a fee schedule lookup tool where you can search by CPT code and specific location. This can help you understand potential costs before receiving a service.
A CPT (Current Procedural Terminology) code is a standardized five-digit code used by healthcare providers to describe medical, surgical, and diagnostic services. These codes are crucial for billing and insurance purposes, providing a universal language for services rendered. Understanding the CPT code for a service can help you research its typical cost and discuss pricing with providers and insurers. Tools like Payerprice use CPT codes to help you look up specific service costs.
To determine if your insurance covers a specific medical service, the best course of action is to contact your insurance provider directly. Provide them with the CPT code for the service if you have it. You can also use tools like Payerprice to get an estimate of the service's cost based on your CPT code and location, which can be a valuable starting point for discussions with your insurer regarding your out-of-pocket expenses.
Comparing prices for healthcare services in your specific area often involves using online price transparency tools. For a comprehensive comparison based on specific CPT codes and locations, Payerprice offers a fee schedule lookup tool. This allows you to input the CPT code for a service and your location to find potential costs, helping you make more informed decisions about where to receive care.
To understand your medical bills, several resources can be helpful. First, always contact your healthcare provider's billing department for clarification on specific charges. Second, review your Explanation of Benefits (EOB) from your insurance company, which details what services were covered and how much you owe. Additionally, to verify the typical costs associated with CPT codes listed on your bill, you can use tools like Payerprice to look up fee schedules based on your location. This can help you cross-reference charges and identify potential discrepancies.