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California rates for HCPCS 80504

Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making. When using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.

Facilitymedian $52 · 10th–90th $35–$1660%10%10th90th$52Professionalmedian $47 · 10th–90th $31–$3160%10%10th90th$47$1.0$5.0$20.0$100.0$500.0

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
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $46.77 / $354.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $36.31 / $144.54
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $61.66 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $31.62 / $95.50
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $58.88 / $81.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $53.70 / $85.11
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $426.58 / $426.58
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $51.29 / $87.10
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $47.86 / $102.33
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $48.98 / $67.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $34.67 / $134.90