Pathology reimbursement
by service line
Compare commercial pathology rates for surgical pathology, special stains, immunohistochemistry, hematology, chemistry, coagulation, and microbiology services.
Compare national pathology rates by payer
Review surgical pathology and immunohistochemistry benchmarks while keeping laboratory disciplines and billing components separate.
Aetna state variation for 88305
National 88305 rate distribution
Each marker shows the national average published rate across billing entities for that payer.
National 88305 rates by payer
| Payer | Rate period | Provider entities | P25 | Median | P75 | P90 | Average |
|---|---|---|---|---|---|---|---|
| Aetna | Q2 2026 | 12,205 | $59.15 | ||||
| Cigna | Q2 2026 | 586 | $64.82 | ||||
| United | Q2 2026 | 18,322 | $65.28 |
- Source
- Negotiated rates published directly by payers in their machine-readable files.
- Rate shown
- Published commercial rate for surgical pathology, gross and microscopic examination (88305).
- Method
- Eligible rates are grouped by payer and billing entity so the benchmarks use a consistent service and billing basis.
The state map uses one consistent Aetna reference series; it does not average already-aggregated payer values. The service-line table keeps unlike codes, settings, and billing units in separate comparisons.
How do specific pathology providers compare?
Compare named provider rates with the selected payer's median and percentile distribution.
Pathology provider rates by payer
| Provider entity | State | Size | $ per service | Gap to median | Position in Aetna range |
|---|
Named provider examples are available in a scoped pathology market comparison.
Choose one state to replace the mixed-state examples with payer-specific provider rates across all three preview codes.
No trial or data preparation required.How reimbursement changes across pathology and laboratory services
Keep surgical pathology, stains, immunohistochemistry, hematology, chemistry, coagulation, and microbiology services in their appropriate billing context.
| Service line / billing code | Nat'l avg | Aetna | Cigna | United | Anthem |
|---|---|---|---|---|---|
$ per service · 5 codes | |||||
88305Surgical pathology, gross and microscopic examination | $59.15 | — | |||
88307Higher-complexity surgical pathology examination | $129.55 | — | |||
88313Special stains, group 2 | $19.15 | — | |||
88341Immunohistochemistry, each additional antibody | $38.91 | — | |||
88342Immunohistochemistry, first antibody | $57.73 | — | |||
$ per service · 4 codes | |||||
85025Complete blood count with automated differential | $12.41 | — | |||
85027Complete blood count without differential | $10.97 | — | |||
85610Prothrombin time | $6.82 | — | |||
85730Partial thromboplastin time | $9.90 | — | |||
$ per service · 9 codes | |||||
81001Automated urinalysis with microscopy | $5.32 | — | |||
81003Automated urinalysis without microscopy | $3.77 | — | |||
82947Quantitative blood glucose assay | $6.63 | — | |||
83605Lactic acid assay | $18.08 | — | |||
83690Lipase assay | $11.34 | — | |||
83735Magnesium assay | $11.03 | — | |||
84100Phosphorus assay | $8.23 | — | |||
84443Thyroid-stimulating hormone assay | $26.03 | — | |||
84484Quantitative troponin assay | $18.97 | — | |||
$ per service · 2 codes | |||||
86900Serologic ABO blood typing | $5.36 | — | |||
87040Bacterial blood culture | $17.59 | — | |||
Tell us the services, payers, states, and networks you need. We'll confirm available coverage and scope the comparison on a 20-minute call.
Book a 20-min scoping call No trial or data preparation required.How these pathology rates are calculated
Use this methodology to understand what each published rate represents and which billing details must match before comparing pathology and laboratory services.
- Rate sourceEach value is a negotiated pathology or laboratory rate published in a payer machine-readable file, not a claim, charge, or utilization estimate.
- Rate calculationNational figures use eligible published rate records across the country; state views use records tied to the selected state. Averages are not weighted by specimen or test volume.
- Provider entityNamed examples use payer-file NPI and TIN records. An entity may represent a laboratory, pathology group, health system, or another billing organization.
- Comparable ratesMatch the exact code, specimen or test method, professional, technical, or global component, modifier, payment unit, payer product, and network. Contract rules may bundle related services.
Get the pathology reimbursement data you're looking for
Choose the services, payers, states, networks, and provider entities relevant to your question. We'll confirm the available coverage and prepare the comparison.
- Tell us your marketShare the specialty, geography, payers, networks, and providers.
- We find comparable ratesPayerPrice aligns billing codes, services, settings, and units.
- Get your market viewSee relevant payer and provider rates organized around your question.
We'll tell you what the data can support, where the gaps are, and the clearest way to structure the comparison.
Trusted by teams that need defensible reimbursement data
How to interpret pathology rates
How to interpret the selected market and payer-published rates.
Which pathology services are represented?
The report includes surgical pathology, special stains, immunohistochemistry, and a selected set of high-volume laboratory services.
Why do professional and technical components matter?
Pathology services may be paid for physician interpretation, technical processing, or both. Those components should not be blended without checking modifier context.
Can all laboratory tests be compared using one unit?
No. Each CPT code represents a distinct test or service and should be interpreted using its own billed unit.
Which billing details change a pathology rate comparison?
Confirm the exact code, specimen or test method, professional, technical, or global component, modifier, payment unit, payer product, and network.
How are named pathology providers selected?
The public table shows billing entities from different points in the selected payer's rate range. An entity may be a laboratory, pathology group, health system, or another billing organization.