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Pathologist Consultation On A Complex Lab Result

North Carolina 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?

$41.69

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $41.69 for this service. The price depends on where it is billed: about $41.69 from a physician practice, and about $42.66 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 6 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$41.69$37.15 to $53.70
FacilityA hospital or hospital-owned outpatient department$42.66$36.31 to $45.71

How much rates vary

Facilitymedian $43 · 10th to 90th $33 to $66Professionalmedian $42 · 10th to 90th $33 to $87
$50$100$200facility $43professional $42

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
Facility
Modifier
Global
Typical Low
$33.11
Median
$36.31
Typical High
$43.65
Aetna
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$37.15
Typical High
$41.69
BCBS
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$48.98
Typical High
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$28.18
Typical High
$74.13
Medcost
Setting
Facility
Modifier
Global
Typical Low
$37.15
Median
$42.66
Typical High
$74.13
Medcost
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$40.74
Typical High
$40.74
United
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$44.67
Typical High
$89.13
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$426.58

Where North Carolina 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.

North Carolina· 31st of 51

$41.69

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.