A nuclear stress test typically costs between $900 and $1,200 before insurance, though the total can range from under $300 to over $4,500 depending on the type of test, where it’s performed, and your insurance coverage. Most people with health insurance pay a fraction of that out of pocket, but the variables involved make it worth understanding what drives the price.
Average Cost by Test Type
Not all nuclear stress tests cost the same. The two main versions, exercise-based and pharmacologic (where a drug simulates exercise for people who can’t use a treadmill), carry noticeably different price tags. An analysis of hospital cost-accounting data published through the National Institutes of Health found that exercise nuclear stress tests averaged $946, while pharmacologic versions averaged $1,132. The roughly $200 difference comes largely from the stress-inducing drug itself, which added about $214 to the pharmacologic test’s cost.
The range within each type is wide. Exercise nuclear stress tests ranged from $280 to $3,052, while pharmacologic tests ranged from $432 to $4,517. That spread reflects differences in facility pricing, geographic location, and how hospitals account for overhead costs like staffing and equipment. The median costs, which filter out extreme outliers, were $898 for exercise and $1,101 for pharmacologic testing.
How It Compares to Other Heart Tests
Nuclear stress testing is one of the more expensive noninvasive cardiac tests. For context, here’s how the options stack up based on the same cost data:
- Exercise EKG (treadmill only, no imaging): $174 average
- Stress echocardiogram (ultrasound-based): $501 to $514 average
- CT angiography: $404 average
- Nuclear stress test: $946 to $1,132 average
The nuclear test costs more because it involves injecting a small amount of radioactive tracer and capturing images with a specialized gamma camera, both before and after the stress portion. That means more materials, more technologist time, and a longer appointment. Your doctor may still recommend it over cheaper alternatives because it provides detailed information about blood flow to your heart muscle that other tests can’t match as reliably, particularly for certain patient profiles.
Hospital vs. Outpatient Facility
Where you have the test done is one of the biggest cost factors within your control. Hospital outpatient departments charge significantly more than freestanding imaging centers or ambulatory surgical centers for the same procedure. Medicare data illustrates this gap clearly: the average patient copayment at a hospital outpatient department is $245, compared to $143 at an ambulatory surgical center. That’s a 70% markup on the patient’s share alone, and the total billed amount follows the same pattern.
If your doctor gives you a choice of locations, an independent cardiology office or outpatient imaging center will almost always be cheaper. The test itself is identical. Hospital-based facilities carry higher overhead costs that get passed along in their pricing. If you’re paying out of pocket or have a high-deductible plan, asking your doctor whether an outpatient facility is an option could save you hundreds of dollars.
What You’ll Pay With Insurance
With private insurance, your out-of-pocket cost depends on three things: whether you’ve met your deductible, your coinsurance or copay percentage, and whether the facility is in-network. If you haven’t met your deductible, you could be responsible for the full negotiated rate, which is typically lower than the sticker price but can still run $500 to $1,000 or more. After meeting your deductible, most plans cover 70% to 90% of the cost, leaving you with a coinsurance payment in the range of $100 to $300.
Medicare Part B covers nuclear stress tests when they’re deemed medically necessary. Based on 2026 Medicare payment rates, patients can expect to pay roughly $143 to $245 out of pocket depending on the facility type, after meeting their Part B deductible. Medicare generally covers 80% of the approved amount, with the patient responsible for the remaining 20%. A Medigap supplemental plan can pick up most or all of that remaining balance.
Why Costs Vary So Much
Several factors explain why one person might pay $200 and another $2,000 for the same test. Geography plays a meaningful role. Costs in major metropolitan areas and states with higher costs of living tend to run well above the national average, while rural areas and lower-cost regions often fall below it. The specific radioactive tracer used also matters, as some are more expensive than others, and your facility may not offer you a choice.
Whether you need the pharmacologic version adds cost automatically. If you can’t exercise to an adequate heart rate due to joint problems, deconditioning, or other limitations, the drug used to dilate your coronary arteries and mimic exercise adds roughly $200 to the bill. This isn’t something you choose; your cardiologist determines which version is appropriate based on your physical ability.
Billing structure varies too. Some facilities bundle the stress test, imaging, and interpretation into a single charge. Others bill separately for the stress portion, the imaging portion, and the physician’s reading of the results, which can make comparing prices difficult. When calling ahead for a price estimate, ask whether the quote includes all three components.
How to Get a Price Estimate
Before your test, you have several ways to pin down what you’ll owe. Start by calling your insurance company with the procedure code (CPT 78452 is the most common code for a nuclear stress test with multiple studies). They can tell you the allowed amount at in-network facilities and what your share will be based on your current deductible status.
Under the No Surprises Act and hospital price transparency rules, many facilities now post prices online or will provide a good-faith estimate if you ask. Call the facility’s billing department directly and request the self-pay or insured rate. If you’re uninsured, ask about cash-pay discounts, as many imaging centers offer reduced rates for upfront payment, sometimes 30% to 50% below the listed price.
If cost is a concern and your doctor has ordered a nuclear stress test, it’s reasonable to ask whether a stress echocardiogram (at roughly half the cost) could provide adequate information for your situation. In some cases it can; in others, the nuclear test offers meaningfully better diagnostic accuracy. That conversation is worth having before you schedule.