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California rates for HCPCS 88307

Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, excision of lesion, requiring microscopic evaluation of surgical margins Breast, mastectomy - partial/simple Cervix, conization Colon, segmental resection, other than for tumor Extremity, amputation, non-traumatic Eye, enucleation Kidney, partial/total nephrectomy Larynx, partial/total resection Liver, biopsy - needle/wedge Liver, partial resection Lung, wedge biopsy Lymph nodes, regional resection Mediastinum, mass Myocardium, biopsy Odontogenic tumor Ovary with or without tube, neoplastic Pancreas, biopsy Placenta, third trimester Prostate, except radical resection Salivary gland Sentinel lymph node Small intestine, resection, other than for tumor Soft tissue mass (except lipoma) - biopsy/simple excision Stomach - subtotal/total resection, other than for tumor Testis, biopsy Thymus, tumor Thyroid, total/lobe Ureter, resection Urinary bladder, TUR Uterus, with or without tubes and ovaries, other than neoplastic/prolapse

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$962.76 / $962.76 / $962.76
Aetna
Facility/Professional
Facility
Modifier
TC
Low / Median / High Price
$604.73 / $604.73 / $604.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.92 / $264.87 / $1,146.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$67.76 / $124.75 / $739.48
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$131.18 / $177.84 / $603.48
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.91 / $161.60 / $552.50
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.25 / $139.74 / $276.25
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$101.32 / $101.32 / $1,027.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.50 / $255.26 / $690.90
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$75.79 / $102.31 / $230.42
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$56.27 / $154.78 / $469.67
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.38 / $207.68 / $483.94
Blue Shield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.08 / $72.55 / $167.58
Blue Shield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$97.99 / $135.13 / $316.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$479.92 / $479.92 / $479.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.42 / $174.14 / $568.70
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.69 / $50.39 / $180.45
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$67.56 / $120.35 / $398.74
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.64 / $375.51 / $506.94
Contra Costa Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.11 / $90.81 / $122.59
Contra Costa Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$17.53 / $284.69 / $384.33
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.87 / $345.62 / $563.34
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.65 / $108.97 / $136.26
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$210.32 / $340.33 / $427.04
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$632.69 / $1,301.88 / $1,535.15
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$193.05 / $358.77 / $395.34
Lucent Health
Facility/Professional
Facility
Modifier
TC
Low / Median / High Price
$450.46 / $943.11 / $1,139.81
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,813.36 / $1,813.36 / $2,402.03
Lucent Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$509.36 / $509.36 / $635.03
Lucent Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$1,303.99 / $1,303.99 / $1,767.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.43 / $229.68 / $324.12
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.00 / $310.00 / $478.05
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.12 / $290.52 / $763.83
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.82 / $52.56 / $213.50
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$66.31 / $123.13 / $493.10
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,052.28 / $1,052.28 / $1,052.28
Sutter Health Plus
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$316.77 / $316.77 / $316.77
Sutter Health Plus
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$735.50 / $735.50 / $735.50
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.73 / $303.73 / $417.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.00 / $210.00 / $210.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.66 / $168.90 / $624.20
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.38 / $53.87 / $192.07
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$79.42 / $125.75 / $482.23