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Sentinel Lymph Node Mapping During Surgery

Pennsylvania rates for HCPCS 38900

During a cancer operation the surgical team traces and identifies the first lymph node or nodes that fluid draining from the tumor would reach, known as the sentinel node, so that node can be found and checked for cancer spread. A dye injected at the site may be used to trace the path, and tracing methods such as a radioactive tracer may be used instead or as well. The mapping is billed in addition to the main operation.

Facilitymedian $3,236 · 10th–90th $407$7,7620%10%10th90th$3,236Professionalmedian $191 · 10th–90th $123$5370%10%20%10th90th$191$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$3,311.31
Typical High
$7,244.36
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$776.25
Median
$5,623.41
Typical High
$16,218.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$190.55
Typical High
$537.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$794.33
Typical High
$15,135.61
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$186.21
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$208.93
Typical High
$288.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$186.21
Typical High
$275.42
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$251.19
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$194.98
Typical High
$263.03
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$3,019.95
Typical High
$5,888.44
Highmark BCBS
Setting
Facility
Modifier
50 · Both sides
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$3,981.07
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$165.96
Typical High
$229.09
Independence Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$707.95
Typical High
$14,454.40
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$186.21
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$1,584.89
Typical High
$6,456.54
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$169.82
Typical High
$323.59
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$213.80
Typical High
$295.12
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$147.91
Typical High
$524.81
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$194.98
Typical High
$524.81
United
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$630.96
Typical High
$4,466.84
United
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$162.18
Typical High
$281.84