A DATSCAN is a specialized diagnostic imaging test that helps medical professionals evaluate adult patients with suspected Parkinsonian syndromes or dementia with Lewy bodies. The procedure involves injecting a small amount of a radioactive material, Ioflupane I 123, which then allows visualization of dopamine transporters in the brain using a Single Photon Emission Computed Tomography (SPECT) scanner. This test is used to help differentiate essential tremor from tremor caused by Parkinsonian syndromes, providing insight into the dopamine system in the brain. For patients and their families, understanding the financial implications of this test is a common concern.
Typical DATSCAN Cost Range
For individuals without insurance coverage or those facing high deductibles, the out-of-pocket cost for a DATSCAN can vary considerably across the United States. A typical single DATSCAN administration can range from approximately $2,500 to $5,000. Some sources indicate the cost for the radiopharmaceutical alone, Ioflupane I 123, might be around $2,539 to $2,813. These figures represent the cost before any insurance adjustments or financial assistance are applied, highlighting the significant expense involved.
What Affects DATSCAN Pricing
Several factors contribute to the wide range of prices observed for a DATSCAN, influencing the final amount a patient might pay. The geographic location where the scan is performed plays a role, with costs potentially differing between states, cities, and even urban versus rural healthcare providers. The type of facility administering the scan also impacts pricing; for instance, hospital outpatient departments may have different pricing structures compared to independent imaging centers or university medical centers.
The listed price for a DATSCAN can also depend on which services are included. Some facilities might offer a bundled price covering the scan itself, the radiopharmaceutical (Ioflupane I 123 Injection), and the radiologist’s interpretation fees. Other providers might unbundle these services, billing each component separately. Additionally, any necessary pre-scan consultations or preliminary tests, such as blood work, could incur separate charges not always included in the initial quoted price.
Insurance and Payment Options
Navigating the payment process for a DATSCAN often involves understanding how insurance coverage applies, as most patients do not pay the full cost out-of-pocket. Medicare Part B generally covers DATSCANs when deemed medically necessary, though patients are typically responsible for deductibles and coinsurance. Similarly, most private insurance plans offer coverage for medically necessary DATSCANs, but the specifics can vary significantly depending on the individual plan, including deductibles, co-pays, co-insurance, and prior authorization requirements. Patients should always contact their specific insurer to understand their coverage details.
For those without adequate insurance coverage or facing high out-of-pocket expenses, several avenues for financial assistance may be available. Some patients have qualified for free scans through hospital financial aid programs, which can significantly reduce the burden. While specific manufacturer-sponsored patient assistance programs for the radiopharmaceutical Ioflupane I 123 may not always be readily available, healthcare providers can offer information on local programs. Imaging facilities may also offer payment plans to help manage costs over time.
Breaking Down Your DATSCAN Statement
A facility fee typically covers the use of the imaging center or hospital equipment and the staff involved in performing the scan. There will also be a charge for the radiopharmaceutical itself, Ioflupane I 123 Injection, which is the tracer administered before the scan. A professional fee will be included for the radiologist’s expert interpretation of the scan images. If a neurologist was involved in ordering or reviewing the scan results, their consultation fees might appear as a separate charge.