Positron emission tomography, better known as PET scans, is a non-invasive digital imaging test that helps doctors diagnose conditions that may be affecting your tissues and internal organs. It uses ionizing radiation in the same way that x-rays do; however, PET scans look at soft tissue instead of focusing on bones and joints.
PET scans involve using a tracer—a chemical that doctors administer through injection, inhalation, or swallowing, depending on the specific organ being examined. The tracer accumulates in areas with higher chemical activity levels, which is often an indication of disease.
According to New Choice Health, the average PET scan costs $5,750 in the United States. However, the price range can go from $1,250 to $9,225!
Several factors contribute to these variations. For one, CT scan machines, such as the Philips CT Brilliance 40, can cost $295,000 – $330,000 per machine. While hospitals can certainly recuperate that cost quickly with the number of patients they receive, there are other factors at play.
Here are three such factors that you should consider if you need to get a PET scan:
Insurance
The price of all hospital procedures, including PET scans, varies if you have medical insurance or not. Unfortunately, there is no industry-wide standard that every insurance provider adheres to, so it’s best to check in with them before getting a scan.
Some insurance providers may cover the entire cost—which means that you won’t have to pay for anything out-of-pocket—while others may only give you partial coverage. If you’re uninsured, you will have to pay for the full cost out-of-pocket.
When talking about insurance, it’s necessary to speak of in-network and out-of-network cost differences as well. An in-network healthcare provider, like a hospital, has a contracted rate with an insurance company.
If your insurance provider and hospital facility are in the same network, they will likely have a negotiated rate to bring the costs down. This makes it more likely for your provider to shoulder more—if not all—of your PET scan costs. For this reason, you must check if a hospital is in the same network as your insurance provider.
Facility Setting
As a general rule, you’ll be paying less for a procedure such as a PET scan if you have it in an outpatient center instead of a hospital facility as an inpatient. Inpatient facilities tend to cost more because you receive more care and are usually given a shared room, food, and a hospital bed.
The location of a facility also plays a role in the cost of a PET scan. Rural facilities can cost more since there are fewer providers that provide competition. This is in contrast to cities where more providers offer the same services. Traveling to a bigger city with more providers to choose from can be a cost-saving solution if the patient can travel safely.
Prescriptions and additional doctor’s visits
Due to certain pre-existing conditions, some people may need painkillers or a sedative before the procedure to avoid any pain or discomfort. Particularly high-risk patients may need additional consultations to ensure that they are ready for a CT scan.
To save on cost, ensure that the prescriptions and doctor’s visits are covered by insurance. If not, ask if the medicines have a generic version that you can purchase for a lower cost!
Conclusion
CT scans are often a non-negotiable aspect of treatment. Doctors use CT scans to confirm their findings and to make a precise diagnosis of your condition. To save on cost, ensure that the hospital and doctor you’re seeing are in the same network with your insurance provider.
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