Cost of PSMA PET scan?

[Balsam01]

I have notied on this forum that there are varying costs of PSMA PET scans. At Duke, I have been informed that my share of the scan could cost as much as $6000. This seems high. Could someone comment on the cost and location of the scans they have received?

[Echotango51]

I had mine done at Trident in Savannah last year. I don’t know what kind of insurance you have, but I think $180 is all I paid. I have a Medicare Advantage Plan.

ET51

[OldVTGuy]

got mine at Dartmouth. I believe the price of you have no insurance is around $5000. I think they charged around $9000 to the insurance company.

[Tall_Allen]

It is covered by Medicare if you use it for any of the 3 purposes it is approved for:

1) recurrence after treatment

2) high-risk localized PCa

3) PSMA-avidity for Pluvicto therapy

If you are using it for another purpose, you may have to pay out of pocket for both the radioindicator and the facility costs.

[Bspouse in reply to Tall_Allen]

I am concerned by this. Medicare paid for first PSMA Pet scan in April 2022 at end of chemo treatment. Husband had a second scan last May 2023 to see if mets decreased ( which thankfully they did). PSA has also continued to decrease. I hope Medicare pays for this 2nd scan.

[dhccpa in reply to Tall_Allen]

Whoever makes the PSMA scan does a hell of a sales job. I'm having to restrain my docs since it won't currently change treatment (I've had three Axumins scans and don't meet one of the three conditions you mentioned). Some posters here also seem to push it under all types of conditions.

[Balsam01 in reply to Tall_Allen]

Thank you!

[fireandice123]

For my PSMA, the Univ of Vermont charged Blue Cross about $20k of which Blue Cross paid about $17k. My cost was $0.

[Break60 in reply to fireandice123]

Outrageous!

[fireandice123 in reply to Break60]

Probably, but I really don’t know. I was just happy I had no out of pocket cost.

[Break60 in reply to fireandice123]

Neither have I had to pay anything being on Medicare. It just blows my mind to see these prices.

[Atdabeach]

I had mine at Johns Hopkins (Sibley Hospital in Washington D.C.) last year. The total billed was around $18,000, and Medicare approved around $1,800. My Medigap picked up whatever Medicare Part B didn't pay (I guess 20% of ~1,800), so I paid nothing.

[Nowhereman9]

$26,0000 UPMC williamsport

[fast_eddie in reply to Nowhereman9]

Ouch.

[countrymusic101]

For all of you not on Medicare (younger men) I found a facility in Vancouver BC that charges around $3,500 for the PSMA pet scan. (Initio Nuclear Medicine)

Better than the price in USA, when your commercial insurance won’t cover it.

[CaptainKrunch]

Prior to updated high risk guidance kicking in (last January) was quoted 10k out of pocket for PSMA Pet by Kaiser of WA.

[j-o-h-n]

F-18 DCFPyL PET/CT was associated with the greatest upfront expenses, costing approximately $25,201 per person; F-18 fluciclovine PET/CT was next in line, costing $18,000 per person and conventional imaging followed close behind at $17,176 per person.

Since F-18 DCFPyL PET/CT is more likely to detect smaller cancers sooner, it eliminates the need for additional imaging and better informs therapy, the authors noted. They added that this also increases patients’ quality-adjusted life years. In the long-term, this equates to lower overall costs than patients would incur if they required multiple scans and rounds of treatment.

The findings support adopting F-18 DCFPyL PET/CT as the standard of care for prostate cancer staging, the authors suggested.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 08/03/2023 3:58 PM DST

[RS265]

Just for a reality check, the Australian Medicare schedule fee for full body PSMA PET is USD850, and no, I didn't drop a zero. A US visitor would be charged about USD1200.

[sillyoyster]

I had them done in south orange county CA. Medicare picked up the entire tab.

[Lunbo]

I have Medicare and Anthem Supp ins. and my PSMAs, and Pluvicto treatments ($230K) have not cost one cent. Zytiga, et al cost $5K but my cp was only $200--can't fiqure out why so many cost profiles for the various drugs--Need a national program..............