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Pathologist Consultation On A Complex Lab Result

Illinois 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?

$45.71

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $45.71 for this service. Most negotiated rates run $40.74 to $57.54.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $46 · 10th to 90th $35 to $78
$50$100professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$43.65
Typical High
$60.26
BCBS
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$58.88
Typical High
$79.43
Cigna
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$27.54
Typical High
$81.28
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$75.86
Typical High
$239.88
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$54.95
Typical High
$87.10

Where Illinois 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.

Illinois· 26th of 51

$45.71

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.