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Iowa 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 $60 · 10th–90th $35–$2000%10%10th90th$60Professionalmedian $43 · 10th–90th $33–$1070%10%20%10th90th$43$10.0$20.0$50.0$100.0$200.0

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
$33.11 / $40.74 / $56.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $60.26 / $120.23
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $75.86 / $199.53
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $61.66 / $208.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $100.00 / $331.13
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $69.18 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $31.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $52.48 / $123.03
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $104.71 / $123.03