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Georgia 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 $54 · 10th–90th $54–$540%50%100%$54Professionalmedian $47 · 10th–90th $29–$1000%20%10th90th$47$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $43.65 / $102.33
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $51.29 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $30.20 / $120.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $58.88 / $117.49
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $51.29 / $112.20