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Utah 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
Professional
Modifier
Low / Median / High Price
$54.00 / $55.25 / $74.98
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$9.18 / $24.67 / $79.98
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$40.00 / $44.33 / $55.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.05 / $46.05 / $91.00
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$5.30 / $13.76 / $24.10
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$22.76 / $34.13 / $69.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.32 / $51.47 / $70.50
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$11.85 / $13.17 / $19.32
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$34.47 / $38.29 / $50.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $41.86 / $83.72
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$7.09 / $7.15 / $17.42
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$17.97 / $32.95 / $59.90