DaTscan — Dopamine Transporter Brain SPECT Imaging (CPT 78803 + A9584): Cost Across Insurances
Complete cell-by-cell comparison across Self-Pay Cash, Original Medicare, 6 Major California Commercial Payers (Anthem, Blue Shield, UnitedHealthcare, Aetna, Cigna, Kaiser Permanente), and Medi-Cal — with every cell labeled with its official data source and effective date.
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Hospital procedure cells are extracted from 14 Bay Area hospital MRFs (45 CFR § 180.50, Oct 2026); medication cells use CMS NADAC (as of 2026-10-28) & CY 2026 Medicare Part D / Medi-Cal Rx rules.
| Parkinson's Service / Medication | Self-Pay / Cash Price Hospital MRF / Retail Cash | Medicare Rate 2026 CMS / NADAC / Part D | Anthem Blue Cross MRF Negotiated / Formulary | Blue Shield of CA MRF Negotiated / Formulary | UnitedHealthcare MRF Negotiated / Formulary | Aetna MRF Negotiated / Formulary | Cigna MRF Negotiated / Formulary | Kaiser Permanente MRF Negotiated / Formulary | Medi-Cal (CA Medicaid) CA DHCS / Medi-Cal Rx |
|---|---|---|---|---|---|---|---|---|---|
Pathway ServiceCPT 78803 DaTscan — Dopamine Transporter Brain SPECT Imaging (CPT 78803 + A9584) | $390–$5,478 Self-pay discounted cash / negotiated spread ($389–$16,079 overall across 14 Bay Area hospitals) Source: 14 Bay Area Hospital MRFs (45 CFR § 180.50) Date: Oct 2026 | $1,308.45 CMS 2026 allowed rate (~$261.69 Part B 20% coinsurance; $0 with Medigap Plan G) Source: CMS CY 2026 Hospital Outpatient Prospective Payment System (OPPS APC 5593 Level 3 Nuclear Medicine) & MPFS (CPT 78803 + HCPCS A9584) Date: CY 2026 (Jan 2026) | $747–$12,230 Negotiated across 6 Bay Area hospital MRFs (e.g., Washington Hospital (Fremont): ANTHEM BC MCR ADV ($774); Washington Hospital (Fremont): ANTHEM BC FEDERAL EMPLOYEES ($1,406)) Source: Bay Area Hospital MRFs (6/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $993–$13,202 Negotiated across 3 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Blue Shield (Medicare Managed Care Plan) ($993); Stanford Tri-Valley (Pleasanton): Blue Shield (HMO/POS) ($2,419)) Source: Bay Area Hospital MRFs (3/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $953–$11,002 Negotiated across 2 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Unitedhealthcare (Medicare Managed Care Plan) ($953); Washington Hospital (Fremont): UHC DOCTORS PLAN PPO/EP ($1,338)) Source: Bay Area Hospital MRFs (2/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $794–$8,688 Negotiated across 1 Bay Area hospital MRFs (e.g., Washington Hospital (Fremont): AETNA MCR ADV ($794); Washington Hospital (Fremont): AETNA-ALL OTHER PLANS ($1,377)) Source: Bay Area Hospital MRFs (1/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $1,208–$13,540 Negotiated across 1 Bay Area hospital MRFs (e.g., Washington Hospital (Fremont): CIGNA NEW BUS OAP ($1,208)) Source: Bay Area Hospital MRFs (1/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $1,051–$9,140 Negotiated across 1 Bay Area hospital MRFs (e.g., Washington Hospital (Fremont): KAISER MEDI-CAL ($1,945); Washington Hospital (Fremont): KAISER - ALL OTHER PLANS ($1,051)) Source: Bay Area Hospital MRFs (1/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $0 patient copay Medi-Cal Fee-For-Service / Managed Care ($0 beneficiary cost-sharing; provider benchmark ~$1,047) Source: CA DHCS 2026 Medi-Cal Rates & Cost-Sharing Rules Date: Oct 2026 |
Every Insurance Cell for DaTscan — With Source & Date Citations
Self-Pay / Discounted Cash Price
Self-pay discounted cash / negotiated spread ($389–$16,079 overall across 14 Bay Area hospitals)
Original Medicare (CMS 2026 / NADAC / Part D)
CMS 2026 allowed rate (~$261.69 Part B 20% coinsurance; $0 with Medigap Plan G)
Anthem Blue Cross (California)
Negotiated across 6 Bay Area hospital MRFs (e.g., Washington Hospital (Fremont): ANTHEM BC MCR ADV ($774); Washington Hospital (Fremont): ANTHEM BC FEDERAL EMPLOYEES ($1,406))
Blue Shield of California
Negotiated across 3 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Blue Shield (Medicare Managed Care Plan) ($993); Stanford Tri-Valley (Pleasanton): Blue Shield (HMO/POS) ($2,419))
UnitedHealthcare (UHC)
Negotiated across 2 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Unitedhealthcare (Medicare Managed Care Plan) ($953); Washington Hospital (Fremont): UHC DOCTORS PLAN PPO/EP ($1,338))
Aetna
Negotiated across 1 Bay Area hospital MRFs (e.g., Washington Hospital (Fremont): AETNA MCR ADV ($794); Washington Hospital (Fremont): AETNA-ALL OTHER PLANS ($1,377))
Cigna
Negotiated across 1 Bay Area hospital MRFs (e.g., Washington Hospital (Fremont): CIGNA NEW BUS OAP ($1,208))
Kaiser Permanente (Northern CA)
Negotiated across 1 Bay Area hospital MRFs (e.g., Washington Hospital (Fremont): KAISER MEDI-CAL ($1,945); Washington Hospital (Fremont): KAISER - ALL OTHER PLANS ($1,051))
Medi-Cal (California Medicaid / Medi-Cal Rx)
Medi-Cal Fee-For-Service / Managed Care ($0 beneficiary cost-sharing; provider benchmark ~$1,047)
Hospital-by-Hospital Published Rates for DaTscan — Dopamine Transporter Brain SPECT Imaging (CPT 78803 + A9584)
| Bay Area Hospital | Self-Pay Cash Price | 2026 Medicare Rate | Negotiated Payer Min–Max | Audited Payer Families |
|---|---|---|---|---|
| UCSF Medical Center (SF) San Francisco • UCSF Health | $390 | $1,308 | $794–$1,589 | Medicare Advantage |
| Stanford Hospital (Palo Alto) Palo Alto • Stanford Medicine | $5,478 | $1,308 | $799–$799 | Medicare Advantage |
| Stanford Tri-Valley (Pleasanton) Pleasanton • Stanford Medicine | $3,316 | $1,308 | $2,066–$5,851 | Blue Shield of California |
| El Camino Health (Mountain View) Mountain View • El Camino Health | $1,119 | $1,308 | Not published | Standard MRF |
| Washington Hospital (Fremont) Fremont • Washington Township Health Care District | $3,888 | $1,308 | $389–$16,079 | Medicare Advantage, Aetna, Medi-Cal / County Managed Care, Anthem Blue Cross, Blue Shield of California, Health Net, UnitedHealthcare, Canopy Health, Cigna, Kaiser Permanente |
| CPMC Van Ness (San Francisco) San Francisco • Sutter Health | $5,048 | $1,308 | Not published | Standard MRF |
| Alta Bates Medical Center (Berkeley) Berkeley • Sutter Health | $5,048 | $1,308 | $772–$772 | Medicare Advantage |
| Summit Medical Center (Oakland) Oakland • Sutter Health | $5,048 | $1,308 | $772–$772 | Medicare Advantage |
| Eden Medical Center (Castro Valley) Castro Valley • Sutter Health | $5,048 | $1,308 | $772–$772 | Medicare Advantage |
| Mills-Peninsula (Burlingame) Burlingame • Sutter Health | $5,048 | $1,308 | $788–$788 | Medicare Advantage |
| Sutter Delta (Antioch) Antioch • Sutter Health | $5,048 | $1,308 | $767–$767 | Medicare Advantage |
| Novato Community Hospital (Marin) Novato • Sutter Health | $5,048 | $1,308 | Not published | Standard MRF |
| Sutter Santa Rosa Regional Santa Rosa • Sutter Health | $5,048 | $1,308 | $747–$747 | Medicare Advantage |
| Sutter Solano (Vallejo) Vallejo • Sutter Health | $5,048 | $1,308 | Not published | Standard MRF |