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Pathologist Consultation On A Complex Lab Result

Iowa rates for HCPCS 80504

This is a pathologist's professional service reviewing an unusual, unexpected, or hard-to-interpret laboratory result and providing expert clinical guidance directly to the treating doctor about what it likely means and how it might affect the patient's care. It is a consultation about test results and their interpretation, not the hands-on examination of a tissue sample under a microscope. It typically happens behind the scenes, without direct involvement of the patient.

Rates data updated July 2026.

How much does Pathologist Consultation On A Complex Lab Result cost?

$47.86

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $47.86 for this service. The price depends on where it is billed: about $45.71 from a physician practice, and about $60.26 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$45.71$40.74 to $81.28
FacilityA hospital or hospital-owned outpatient department$60.26$48.98 to $87.10

How much rates vary

Facilitymedian $60 · 10th to 90th $35 to $200Professionalmedian $46 · 10th to 90th $35 to $162
$50$100$200facility $60professional $46

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$45.71
Typical High
$162.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$60.26
Typical High
$120.23
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$75.86
Typical High
$199.53
Medica
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$61.66
Typical High
$208.93
Medica
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$100.00
Typical High
$331.13
Midlands
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$63.10
Typical High
$138.04
United
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$31.62
United
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$54.95
Typical High
$128.82
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$91.20
Typical High
$114.82

Where Iowa sits

The same service costs 3.0 times more in Minnesota than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Iowa· 19th of 51

$47.86

MN $102DE $33.88

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.