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Vermont rates for HCPCS 88305

Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, biopsy, not requiring microscopic evaluation of surgical margins Breast, reduction mammoplasty Bronchus, biopsy Cell block, any source Cervix, biopsy Colon, biopsy Duodenum, biopsy Endocervix, curettings/biopsy Endometrium, curettings/biopsy Esophagus, biopsy Extremity, amputation, traumatic Fallopian tube, biopsy Fallopian tube, ectopic pregnancy Femoral head, fracture Fingers/toes, amputation, non-traumatic Gingiva/oral mucosa, biopsy Heart valve Joint, resection Kidney, biopsy Larynx, biopsy Leiomyoma(s), uterine myomectomy - without uterus Lip, biopsy/wedge resection Lung, transbronchial biopsy Lymph node, biopsy Muscle, biopsy Nasal mucosa, biopsy Nasopharynx/oropharynx, biopsy Nerve, biopsy Odontogenic/dental cyst Omentum, biopsy Ovary with or without tube, non-neoplastic Ovary, biopsy/wedge resection Parathyroid gland Peritoneum, biopsy Pituitary tumor Placenta, other than third trimester Pleura/pericardium - biopsy/tissue Polyp, cervical/endometrial Polyp, colorectal Polyp, stomach/small intestine Prostate, needle biopsy Prostate, TUR Salivary gland, biopsy Sinus, paranasal biopsy Skin, other than cyst/tag/debridement/plastic repair Small intestine, biopsy Soft tissue, other than tumor/mass/lipoma/debridement Spleen Stomach, biopsy Synovium Testis, other than tumor/biopsy/castration Thyroglossal duct/brachial cleft cyst Tongue, biopsy Tonsil, biopsy Trachea, biopsy Ureter, biopsy Urethra, biopsy Urinary bladder, biopsy Uterus, with or without tubes and ovaries, for prolapse Vagina, biopsy Vulva/labia, biopsy

Facilitymedian $295 · 10th–90th $85–$9330%10%20%10th90th$295Professionalmedian $141 · 10th–90th $35–$8510%10%10th90th$141$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $288.40 / $724.44
Aetna
Facility/Professional
Facility
Modifier
TC
Typical Low / Median / Typical High
$302.00 / $302.00 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $131.83 / $147.91
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$35.48 / $154.88 / $912.01
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$26.92 / $61.66 / $85.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $123.03 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $102.33 / $251.19
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$35.48 / $52.48 / $128.82
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$33.88 / $46.77 / $81.28
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $70.79 / $102.33
MVP Health Care
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$35.48 / $36.31 / $52.48
MVP Health Care
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$32.36 / $33.88 / $50.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $85.11 / $141.25
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$23.44 / $44.67 / $57.54
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.50 / $41.69 / $83.18