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North Carolina 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

Facilitymedian $224 · 10th–90th $62–$6170%10%20%10th90th$224Professionalmedian $229 · 10th–90th $74–$8510%5%10th90th$229$20.0$100.0$500.0$2.0K$10.0K

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
$43.65 / $229.09 / $741.31
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$61.66 / $66.07 / $123.03
Aetna
Facility/Professional
Facility
Modifier
TC
Typical Low / Median / Typical High
$63.10 / $165.96 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $239.88 / $724.44
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$64.57 / $281.84 / $933.25
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$138.04 / $162.18 / $457.09
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$37.15 / $93.33 / $181.97
Ambetter
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$67.61 / $134.90 / $169.82
BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$100.00 / $165.96 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $162.18 / $436.52
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$38.02 / $57.54 / $141.25
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$50.12 / $95.50 / $309.03
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $316.23
Medcost
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$147.91 / $147.91 / $151.36
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $275.42 / $446.68
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $190.55 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $245.47 / $478.63
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$46.77 / $81.28 / $173.78
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$75.86 / $147.91 / $331.13
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
Wellcare
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Wellcare
Facility/Professional
Facility
Modifier
TC
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,318.26
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $2,398.83
Wellcare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$512.86 / $512.86 / $630.96
Wellcare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,778.28