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Maine 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.

Professionalmedian $43 · 10th–90th $29–$630%10%10th90th$43$1.0$2.0$5.0$10.0$20.0$50.0$100.0

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
$28.84 / $37.15 / $50.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $51.29 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.56 / $47.86 / $61.66
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $54.95 / $63.10
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $41.69 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $47.86 / $83.18