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Both-Sides Heart Cath For Congenital Defect

New Jersey rates for HCPCS 93596

A catheter study of a heart with a defect present from birth. Thin tubes are guided through blood vessels into both the right and the left sides of the heart to measure pressures and oxygen levels and to map how blood is actually flowing through the abnormal anatomy. The findings guide whether and how the defect should be repaired.

Rates data updated October 2026.

How much does Both-Sides Heart Cath For Congenital Defect cost?

$2,884

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $2,884 for this service. The price depends on where it is billed: about $871 from a physician practice, and about $5,248 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$871$363 to $1,660
FacilityA hospital or hospital-owned outpatient department$5,248$3,467 to $9,772

How much rates vary

Facilitymedian $5,248 · 10th to 90th $2,042 to $14,125Professionalmedian $871 · 10th to 90th $302 to $2,344
$500$1K$2K$5K$10K$20Kfacility $5,248professional $871

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$5,128.61
Median
$10,471.29
Typical High
$19,952.62
Aetna
Setting
Facility
Modifier
26 · Professional part
Typical Low
$331.13
Median
$346.74
Typical High
$346.74
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$1,202.26
Median
$1,737.80
Typical High
$21,379.62
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$302.00
Median
$331.13
Typical High
$398.11
Cigna
Setting
Facility
Modifier
None
Typical Low
$4,677.35
Median
$11,220.18
Typical High
$12,302.69
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$1,348.96
Median
$2,344.23
Typical High
$4,570.88
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$309.03
Median
$354.81
Typical High
$707.95
Emblem Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$1,949.84
Horizon BCBS
Setting
Facility
Modifier
None
Typical Low
$2,511.89
Median
$4,677.35
Typical High
$13,182.57
Horizon BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$302.00
Median
$380.19
Typical High
$1,380.38
Horizon BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$302.00
Median
$354.81
Typical High
$812.83
United
Setting
Facility
Modifier
None
Typical Low
$1,548.82
Median
$4,073.80
Typical High
$9,772.37
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$309.03
Median
$870.96
Typical High
$2,238.72
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$275.42
Median
$407.38
Typical High
$851.14
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$724.44
Median
$1,288.25
Typical High
$1,778.28

Where New Jersey sits

The same service costs 14.5 times more in California than in Maine. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Jersey· 11th of 51

$2,884

CA $8,128ME $562

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.