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Billing code 88307 · Lab & pathology

88307 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $151.29 for 88307 across 50 states, from $34.00 in Pennsylvania to $310.63 in Hawaii.

Data as of Oct 5, 202650 statesEvery rate links to its official source

States publishing
50
National median
$151.29units vary by state
Lowest
$34.00Pennsylvania
Highest
$310.63Hawaii
Answer

What does Medicaid pay for 88307?

50 state Medicaid programs publish a fee-for-service rate for 88307. The national median is $151.29 (units differ between states). Hawaii pays the most, $310.63, and Pennsylvania the least, $34.00, a 9.1x spread.

Medicare (non-facility, 2026 physician fee schedule): $245.21–$381.42 depending on the state's Medicare locality.

State ranking

88307 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 50 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Hawaii Source · since 2026-06-01$310.63——Plans negotiate; applies out of network—
2Alaska Source · since 2026-07-01$297.75——Not classified—
3Arizona Source · since 2026-10-01$286.81——Plans negotiate; applies out of network—
25Kansas Source · since 2023-07-01$155.59——Plans must pay at least this—
26Ohio Source · since 2025-04-01$146.99——Plans negotiate; applies out of network—
27South Carolina Source · since 2024-07-01$146.13——Not classified—
49New Hampshire Source · since 2023-07-01$35.03——Plans negotiate; applies out of network—
50Pennsylvania Source · since 2015-10-01$34.00——Plans negotiate; applies out of network—
See all 50 states for 88307 — start free

42 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 88307 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for 88307, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 45 of the 50 states list more than one rate for 88307, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. Of the 50 states, 1 publish 88307 per unit, and 49 schedules print no unit at all (a flat amount per service).
  • Per hour. 88307 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. Medicare amounts exist for 88307, but no state's Medicaid unit matches Medicare's billing unit closely enough to compute a percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why 88307 rates differ between states

Published rates for 88307 run from $34.00 in Pennsylvania to $310.63 in Hawaii, a 9.1x gap in the same unit. Half the states pay more than the median of $151.29 and half pay less. The usual reasons for a spread like this in lab & pathology rates:

  • Many states set clinical laboratory fees with reference to the Medicare Clinical Laboratory Fee Schedule, but at different percentages and from different update years.
  • Pathology services with an interpretation have professional and technical components that states price separately.
  • Some states bundle certain tests into panels or into facility payments, so the separately billable amount differs.

Timing matters too. 29 states set the current rate for 88307 in 2026 or later, while 9 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for 88307

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For 88307, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 27 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 15 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (27 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (8 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Hawaii managed care.

Billing

Units and billing for 88307

88307 is a CPT pathology and laboratory code in the lab & pathology line, billed mostly by independent laboratories, hospital labs and pathology groups. Laboratory codes are paid per test; a panel is paid as one code, not as the sum of its tests. Pathology codes with an interpretation can be split into professional and technical components.

Pathology interpretation can be billed with modifier 26 when the laboratory and the pathologist bill separately. Laboratory tests are billed per test, and a panel is paid as a single code rather than as the sum of its component tests.

Medicare's 2026 physician fee schedule pays $245.21–$381.42 for 88307 (non-facility), depending on the Medicare locality. That is a useful reference point, but Medicare and Medicaid can define the unit differently, so compare only where the units match.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for 88307?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $151.29. Hawaii pays the most ($310.63) and Pennsylvania the least ($34.00).

Which state pays the highest Medicaid rate for 88307?

Hawaii, at $310.63, effective 2026-06-01.

Which state pays the lowest Medicaid rate for 88307?

Pennsylvania, at $34.00, effective 2015-10-01.

What unit is 88307 billed in?

Of the 50 states, 1 publish 88307 per unit, and 49 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 88307?

Not necessarily. In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 27 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 15 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.