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Alaska rates for HCPCS 88304

Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartholin's gland cyst Bone fragment(s), other than pathologic fracture Bursa/synovial cyst Carpal tunnel tissue Cartilage, shavings Cholesteatoma Colon, colostomy stoma Conjunctiva - biopsy/pterygium Cornea Diverticulum - esophagus/small intestine Dupuytren's contracture tissue Femoral head, other than fracture Fissure/fistula Foreskin, other than newborn Gallbladder Ganglion cyst Hematoma Hemorrhoids Hydatid of Morgagni Intervertebral disc Joint, loose body Meniscus Mucocele, salivary Neuroma - Morton's/traumatic Pilonidal cyst/sinus Polyps, inflammatory - nasal/sinusoidal Skin - cyst/tag/debridement Soft tissue, debridement Soft tissue, lipoma Spermatocele Tendon/tendon sheath Testicular appendage Thrombus or embolus Tonsil and/or adenoids Varicocele Vas deferens, other than sterilization Vein, varicosity

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.04 / $285.18 / $570.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.98 / $167.45 / $167.45
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$12.81 / $50.63 / $347.80
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$51.61 / $116.82 / $116.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.53 / $65.53 / $65.53
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$14.74 / $14.74 / $14.74
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$50.79 / $50.79 / $50.79
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $218.25 / $225.04
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.87 / $30.87 / $30.87
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$71.08 / $71.08 / $71.08
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.05 / $160.00 / $234.24
Premera BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$15.09 / $41.25 / $60.39
Premera BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$41.96 / $118.75 / $173.85
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.53 / $161.25 / $214.60
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$14.74 / $41.25 / $62.90
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$50.79 / $120.00 / $151.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.53 / $148.53 / $148.53
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$48.54 / $48.54 / $48.54
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$99.99 / $99.99 / $99.99