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Massachusetts 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 $58 · 10th–90th $44–$2140%10%20%10th90th$58Professionalmedian $50 · 10th–90th $36–$1260%10%10th90th$50$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $42.66 / $131.83
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $61.66 / $162.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $67.61 / $213.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $91.20 / $123.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $43.65 / $91.20
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $52.48 / $79.43
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $70.79 / $107.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $56.23 / $63.10
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $61.66 / $162.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $54.95 / $114.82