Compare PET Scan Cost
Welcome to ComparePetScanCost.com where you can:
- Learn about PET (Positron Emission Tomography) scan procedures
- Determine average cost and pricing for a PET scan
- Lean how reimbursement for PET scan cost works
- Learn how to work with the system, whether insured or uninsured, to get the best price for a PET Scan
PET Scan Cost Basics
First and foremost, you have a choice so make sure you shop for where you get your PET scan because it might save you a significant amount of money. By doing a little homework and shopping around you can save hundreds, if not thousands, of dollars. PET scans costs can range between $3,000 - $6,000. Costs are broken down into three areas:
FDG Radiopharmaceutical Fees: this is the cost of the radioactive element that is used to produce the images
Technical Fees: this is the cost of the procedure and where there is a potential to save a considerable amount of money
Professional Fees: this is the fee associated with having the radiologist interpret the test result.
When speaking with testing facilities make sure you identify the complete cost of the PET scan procedure and not just the technical fees of the procedure. These fees can add up quickly and lead to very large bills and unexpected costs. Although PET scan cost are considered high when compare to other imaging procedures, often PET scans have proven to lower diagnostic work-up in certain situations by avoiding unnecessary invasive diagnostic and surgical procedures in patients where the procedures performed do little to help diagnose the condition. Therefore more and more insurance companies are offering to reimburse for PET scans.
General Cancellation Policies
Most hospitals and imaging centers have no cost for cancellations received 24 hours prior to the appointment. If you cancel the procedure within 24 hours you can expect a charge ranging from $100 to $750. These cost/charges are associated with the missed appointment as well as the tracer solution which is used in the PET scan procedure. These tracers have a very short shelf-life and cannot be replaced or stored for use by other patents. Therefore imaging facilities will often pass this cost on to you if you cancel or no-show for an appointment within 24 hours of a scheduled procedure.
Besides typical insurance reimbursement, which is discussed below, most imaging centers accept payments made by cash, check, MasterCard, Visa, Discover, and American Express credit cards. For customers with insurance, most imaging facilities require any out-of-pocket deductible or co-payment be paid upon office visit. For customers who are uninsured, most imaging facilities will often extend a discount of 15%-40% for patients who pay the full discounted amount by cash or credit within 60 days of the procedure.
Most hospitals and imaging centers do not charge for appointments which are cancelled within 24 hours of the scheduled appointment or procedure. If you do cancel the procedure within 24 hours most facilities will charge you a cancellation fee of $100 to $750. These cost/fees are associated with lost income opportunity of having the CT scan machine in use during the scheduled appointment. If the machine is not being used for a procedure then it is just costing the imaging facility or hospital money. Therefore make sure that you do not cancel within 24 hours of appointment or just no-show because you will most likely be charged a cancellation fee which is not reimbursable by your insurance company.
In addition to accepting typical medical insurance reimbursement, most all hospitals and imaging centers accept the following payment methods; cash, check, MasterCard, Visa, Discover, and American Express credit cards. Most all testing facilities require any out-of-pocket deductible or co-payment be paid upon office visit. For uninsured customers, most testing facilities offer 15% - 40% discount when the full discounted amount is paid by cash or credit within 60 days of the procedure.
Costs Reimbursement - Insured Customers
Usually Medicare, as well as third party insurance companies, will reimburse the cost of many PET scans. Some indications have already been determined to be reimbursable, others are reimbursed as long as they are clinically indicated. To be clinically indicated, the PET scan must be potentially beneficial in providing information supportive of a diagnosis or monitoring certain conditions, and be considered medically necessary. It is essential for you to know if your insurance requires pre-certification in order for payment to be made for your services. Please notify the imaging doctor or technician if pre-certification is required prior to any elective tests or procedures. If you do not pre-certify a test or procedure this may result in denial of your insurance claim. Since PET is a growing field, the published data sometimes lags behind coverage policies. The indication may be covered, even if it is not on the standard coverage list. Therefore, it is important that your insurance company is contacted to determine your eligibility.
Medicare limits coverage of FDG PET to use by high-end full ring dedicated PET scanners. (Alternative Hybrid PET cameras, such as dual head Gamma Cameras equipped with molecular coincidence detection or Gamma Cameras equipped with 511 KEV collimators have been shown to be vastly inferior in sensitivity and exams performed by these hybrid devices are not approved by Medicare for reimbursement purposes.) Medicare is constantly updating reimbursements, so make sure you ask before your procedure or visit the Medicare website at www.medicare.gov to find the latest information.
Costs Reimbursement - Uninsured Customers
If you are uninsured and will be paying with cash or credit card such as MasterCard, Visa, or American Express, many imaging centers will extend a discount from the total billed charges for your services. Typical discounts range from 15%-40% if the discounted balance is paid in full within 60 days. Depending on your financial status and specific situation, a greater discount or charity may apply or you may find an alternative way to work with the imaging center for payment and cost reimbursement.
Costs Reimbursement - Other Alternatives & Options
Below are some additional opportunities to receive assistance in alleviating the cost of a PET scan, which depends upon your person financial and/or personal situation.
Payment Plans: Hospitals and diagnostic imaging centers generally do not accept payment plans, but exceptions can be accommodated in extreme financial hardship cases. So if the cost of a PET scan puts you in a financially vulnerable position do not hesitate to ask for some type of payment plan.
Charity Care Qualifications: If your family income and assets are within 200% of Federal Poverty Guidelines, financial assistance may be provided. Imaging centers and hospitals often consider these on a case by case basis. If you meet the initial screening criteria the facility may need to review your federal income tax returns, current pay stubs, and/or denial of third party benefits.
Employees Group Benefit Program: If you are a participating employee in a Group Benefit Program at work, you and your employer can arrange to have the cost of your PET scan paid for under the program by your employer's group insurance carrier on an "extra-contractual" basis. The terms vary from plan to plan, but group benefit programs invariably provide for such "extra-contractual" arrangements. The expense is tax-deductible to the employer so make sure you speak with your employer before you pay for your PET scan.
Tax Credits : If you do end up having to pay for the cost of a PET scan you may be eligible for a medical tax credit. Make sure you keep your paperwork and receipt and speak with an accountant. This may be very helpful for people who are retired and may save you hundreds of dollars in taxes.
PET Scan Cost Rule of Thumb
- Shop around for the best possible PET scan procedure rate. Doing your research can save you hundreds, if not thousands, of dollars!
- Freestanding imaging centers often are more open to negotiating prices than hospitals.
- If you are paying up front or participate in a Health Savings Account ask for the best possible PET scan rate which is often much less than the facilities published "charge."
PET Scan Procedure Basics
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Positron Emission Tomography, also called PET imaging or a PET scan, is a diagnostic examination that involves the acquisition of physiologic images based on the detection of radiation from the emission of positrons. Positrons are tiny particles emitted from a radioactive substance administered to the patient. The subsequent images of the human body developed with this technique are used to evaluate a variety of diseases. PET scans have become very popular because no other imaging technology shows the internal chemistry of the body so well. A PET scan has the unique ability to identify chemical and metabolic changes in diseases such as cancer before anatomic and structural changes which are detected by other imaging technologies have time to develop. Therefore PET can detect diseases when anatomic imaging studies are still normal, and may be informative in differentiating benign from malignant process. This makes PET scans very popular in identifying whether cancer is present or not, if it has spread, if it is responding to treatment, and if a person is cancer free after treatment. Cancers for which PET scans are considered particularly effective include lung, head and neck, colorectal, esophageal, lymphoma, melanoma, breast, thyroid, cervical, pancreatic, and brain as well as other cancers.
How does a PET Scan work?
Before the examination begins, a radioactive substance (FDG) is produced in a machine called a cyclotron and attached, or tagged, to a natural body compound, most commonly glucose, but sometimes water or ammonia. Once this substance is administered to the patient, the radioactivity localizes in the appropriate areas of the body and is detected by the PET scanner. Different colors or degrees of brightness on a PET image represent different levels of tissue or organ function. For example, because healthy tissue uses glucose for energy, it accumulates some of the tagged glucose, which will show up on the PET images. However, cancerous tissue, which uses more glucose than normal tissue, will accumulate more of the substance and appear brighter than normal tissue on the PET images.
Difference Between PET Scan and CT and MRI?
PET scans differ from CT and MRI scans in that PET scans are metabolic imaging as opposed to anatomic imaging. CT and MRI scans are anatomic imaging modalities, which means they look at the size and shape of organs and body structures. A PET scan is a metabolic imaging modality, which means it looks at function.
The information contained on this page is for information purposes only and should not be taken as medical advice. Please consult your physician on any medical conditions, diagnostic testing, or any general medical issue.