Home › CPT Codes › Performing nuclear imaging of heart muscle function at rest and during stress with multiple SPECT evaluations

CPT 78452: Performing nuclear imaging of heart muscle function at rest and during stress with multiple SPECT evaluations - Prior Authorization and Price

CPT code 78452 is Performing nuclear imaging of heart muscle function at rest and during stress with multiple SPECT evaluations. See what Aetna, Anthem BCBS, Cigna, UnitedHealthcare look for before approving it, the conditions their guidelines cover, and what it typically costs.

CPT 78452

Performing nuclear imaging of heart muscle function at rest and during stress with multiple SPECT evaluations.

Nuclear Medicine

Build a submission checklist for this study

Payer guidelines that apply

Payer	Reviewed using	Guideline	Sections
Aetna	eviCore	Abdomen Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Cardiac Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Cardiac Imaging Guidelines effective Feb 3, 2026	6 that name this code
Anthem BCBS	Carelon	Imaging of the heart effective Nov 15, 2025	4 that name this code
Cigna	eviCore	Abdomen Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Cardiac Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Cardiac Imaging Guidelines 1.0.2026, effective Feb 3, 2026	6 that name this code
Medicare	CMS	—	None found
Original Medicare does not run a prior authorization program for outpatient imaging; claims are judged against the coverage policies above. Medicare Advantage plans set their own prior authorization rules.
UnitedHealthcare	UnitedHealthcare / eviCore	Commercial and Exchange Cardiovascular and Radiology Imaging Guidelines 09.2026, effective Sep 1, 2026	6 that name this code

Guidelines collected from the payers' published documents on September 29, 2026. Payers revise these documents during the year. Open the guideline link to confirm the current version before you submit.

Conditions the guidelines address for this study

These are the clinical situations where payer guidelines discuss Performing nuclear imaging of heart muscle function at rest and during stress with multiple SPECT evaluations. Each has its own criteria for when the study is considered appropriate.

Transplant Aetna · Cigna · UnitedHealthcare
Cardiac Imaging in Transplants Aetna · Cigna · UnitedHealthcare
Established flow-limiting CAD in asymptomatic patients Anthem BCBS
Established or suspected CAD Anthem BCBS
Indications are organized as follows Anthem BCBS
Suspected CAD in symptomatic patients who have not had evaluation for CAD within the preceding 60 days Anthem BCBS

Typical price

Commercial insurance, median

$2,248

Middle half of rates: $1,367 to $3,779

Medicare, hospital outpatient

$1,323

Facility payment

Medicare, physician fee schedule

$430

National, non-facility

Commercial figures come from negotiated rates published by 990 hospitals; Medicare figures from CMS fee schedules. Rates vary widely by hospital and plan. Pricing data from CenterIQ.

Get notified when the rules for this study change

Payers update imaging guidelines several times a year. We will email you when the criteria for Performing nuclear imaging of heart muscle function at rest and during stress with multiple SPECT evaluations change.

CPT 78452: Performing nuclear imaging of heart muscle function at rest and during stress with multiple SPECT evaluations - Prior Authorization and Price

Payer guidelines that apply

Conditions the guidelines address for this study

Typical price

Get notified when the rules for this study change

Frequently asked questions

Imaging CPT Code Coverage Lookup

Quick Access - Common Imaging CPT Codes

CT

MRI

MRA

PET