The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 78811. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
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Publishing states
43
Median % of Medicare
--
Rate range
$51.76 - $2,594.68
78811 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $111.11 | -- | -- | 2026 |
| Alabama | $1,985.94 | -- | -- | 2026 |
| Arkansas | $1,558.25 | -- | -- | 2026 |
| Arizona | $1,351.63 | -- | -- | 2020 |
| California | $2,027.01 | -- | -- | 2026 |
| Colorado | $1,562.10 | -- | Required | 2026 |
| Connecticut | $1,294.00 | -- | Required | 2015 |
| District of Columbia | $237.50 | -- | Varies | 2005 |
| Delaware | $1,347.89 | -- | -- | 2026 |
| Iowa | $784.21 | -- | -- | 2024 |
| Idaho | $538.47 | -- | Not required | 2026 |
| Illinois | $127.27 | -- | -- | 2026 |
| Indiana | $1,313.34 | -- | Required | 2025 |
| Kansas | $1,080.97 | -- | -- | 2023 |
| Kentucky | $1,036.97 | -- | Required | 2026 |
| Louisiana | $910.40 | -- | -- | 2026 |
| Massachusetts | $51.76* | -- | -- | 2025 |
| Maine | $929.16 | -- | -- | 2026 |
| Michigan | $756.80 | -- | -- | 2026 |
| Minnesota | $437.66 | -- | -- | 2026 |
| Missouri | $728.59 | -- | Required | 2022 |
| Mississippi | $1,059.86 | -- | -- | 2026 |
| Montana | $474.28 | -- | -- | 2026 |
| North Carolina | $848.97 | -- | -- | 2025 |
| North Dakota | $1,389.89 | -- | Not required | 2026 |
| Nebraska | $1,150.54 | -- | -- | 2026 |
| New Hampshire | $1,130.17 | -- | Required | 2026 |
| New Jersey | $722.60 | -- | Not required | 2026 |
| New Mexico | $2,594.68 | -- | -- | 2025 |
| Nevada | $725.18 | -- | -- | 2024 |
| New York | $574.69 | -- | -- | 2026 |
| Ohio | $594.03 | -- | -- | 2018 |
| Oklahoma | $1,168.17 | -- | -- | 2026 |
| Oregon | $55.41* | -- | -- | 2026 |
| Rhode Island | $1,523.85 | -- | -- | 2026 |
| South Carolina | $683.12 | -- | -- | 2011 |
| Texas | $1,143.11* | -- | -- | 2026 |
| Utah | $66.17* | -- | Not required | 2026 |
| Virginia | $1,288.00 | -- | -- | 2009 |
| Vermont | $57.27 | -- | -- | 2026 |
| Washington | $877.47 | -- | -- | 2026 |
| West Virginia | $884.74 | -- | -- | 2026 |
| Wyoming | $60.98 | -- | -- | 2026 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related lab & imaging codes
- 70030 - X-ray of the eye for a foreign body
- 70100 - Jaw (mandible) X-ray, up to 3 views
- 70110 - Jaw (mandible) X-ray, 4 or more views
- 70120 - X-ray of the mastoids, under 3 views per side
- 70130 - X-ray of the mastoids, complete
- 70134 - X-ray of the inner ear canals, complete
- 70140 - Facial bone X-ray, under 3 views
- 70150 - Facial bone X-ray, complete, 3 or more views
Frequently asked questions
How much does Medicaid pay for 78811?
43 state Medicaid programs publish a fee-for-service rate for 78811 (pET scan, limited area), ranging from $51.76 in Massachusetts to $2,594.68 in New Mexico. The full table on this page lists every publishing state's current rate.
Which state pays the most for 78811?
New Mexico publishes the highest Medicaid rate for 78811 at $2,594.68. Massachusetts publishes the lowest at $51.76.
Does 78811 require prior authorization under Medicaid?
6 of the 43 publishing states flag 78811 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".