go back

Pathologist Consultation On A Complex Lab Result

Montana 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?

$81.28

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $81.28 for this service. Most negotiated rates run $79.43 to $91.20.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $87 · 10th to 90th $79 to $102Professionalmedian $81 · 10th to 90th $33 to $93
$50$100$200$500facility $87professional $81

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

Where Montana 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.

Montana· 5th of 51

$81.28

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.