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Pathologist Consultation On A Complex Lab Result

Maine 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?

$47.86

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $47.86 for this service. Most negotiated rates run $42.66 to $63.10.

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 $48 · 10th to 90th $38 to $63
$50$100professional $48

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
$38.02
Median
$42.66
Typical High
$50.12
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$48.98
Typical High
$89.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.56
Median
$47.86
Typical High
$61.66
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$54.95
Typical High
$63.10
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$42.66
Typical High
$67.61
United
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$47.86
Typical High
$83.18

Where Maine 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.

Maine· 21st of 51

$47.86

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.