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Pathologist Consultation On A Complex Lab Result

Massachusetts 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?

$54.95

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $54.95 for this service. The price depends on where it is billed: about $54.95 from a physician practice, and about $57.54 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 8 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$54.95$42.66 to $72.44
FacilityA hospital or hospital-owned outpatient department$57.54$48.98 to $87.10

How much rates vary

Facilitymedian $58 · 10th to 90th $44 to $214Professionalmedian $55 · 10th to 90th $36 to $132
$50$100$200facility $58professional $55

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
$33.11
Median
$40.74
Typical High
$165.96
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$61.66
Typical High
$158.49
BCBS
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$67.61
Typical High
$213.80
BCBS
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$95.50
Typical High
$141.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$46.77
Typical High
$100.00
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$52.48
Typical High
$79.43
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$72.44
Typical High
$109.65
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$56.23
Typical High
$63.10
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$61.66
Typical High
$158.49
United
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$52.48
Typical High
$117.49

Where Massachusetts 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.

Massachusetts· 16th of 51

$54.95

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.