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Pathologist Consultation On A Complex Lab Result

Kentucky 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?

$36.31

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $36.31 for this service. The price depends on where it is billed: about $36.31 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 6 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$36.31$21.38 to $41.69
FacilityA hospital or hospital-owned outpatient department$60.26$51.29 to $79.43

How much rates vary

Facilitymedian $60 · 10th to 90th $40 to $79Professionalmedian $36 · 10th to 90th $21 to $55
$20$50$100facility $60professional $36

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
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$39.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$37.15
Typical High
$47.86
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$21.38
Typical High
$21.38
CareSource
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$60.26
Typical High
$81.28
CareSource
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$60.26
Typical High
$87.10
Cigna
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
Cigna
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$46.77
Typical High
$245.47
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$53.70
Typical High
$89.13

Where Kentucky 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.

Kentucky· 47th of 51

$36.31

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.