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Montana 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 $87 · 10th–90th $79–$1020%20%40%10th90th$87Professionalmedian $55 · 10th–90th $29–$890%10%20%10th90th$55$50.0$100.0$200.0$500.0

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 / $38.90 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $83.18
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $89.13 / $102.33
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $89.13 / $102.33
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $83.18 / $114.82
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $79.43 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $33.11 / $87.10