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CPT 78491: Analyzing blood circulation in heart muscle using nuclear medicine both at rest and under stress conditions - Prior Authorization and Price

CPT code 78491 is Analyzing blood circulation in heart muscle using nuclear medicine both at rest and under stress conditions. See what Aetna, Cigna, UnitedHealthcare look for before approving it, the conditions their guidelines cover, and what it typically costs.

CPT 78491

Analyzing blood circulation in heart muscle using nuclear medicine both at rest and under stress conditions.

Nuclear Medicine
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Payer guidelines that apply

PayerReviewed usingGuidelineSections
Aetna eviCore
Cardiac Imaging Guidelines 2.0.2026, effective Sep 1, 2026
 4 that name this code
Anthem BCBS Carelon Current guideline None found
Cigna eviCore
Cardiac Imaging Guidelines 2.0.2026, effective Sep 1, 2026
Pediatric Cardiac Imaging Guidelines 1.0.2026, effective Feb 3, 2026
 4 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 4 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 Analyzing blood circulation in heart muscle using nuclear medicine both at rest and under stress conditions. Each has its own criteria for when the study is considered appropriate.

  • Cardiac Imaging in Transplants Aetna · Cigna · UnitedHealthcare

Typical price

Commercial insurance, median
$2,324
Middle half of rates: $1,749 to $3,727
Medicare, hospital outpatient
$1,461
Facility payment
Medicare, physician fee schedule
$71
National, non-facility

Commercial figures come from negotiated rates published by 479 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 Analyzing blood circulation in heart muscle using nuclear medicine both at rest and under stress conditions change.

Frequently asked questions

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