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North Carolina 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 $43 · 10th–90th $33–$620%20%10th90th$43Professionalmedian $41 · 10th–90th $33–$930%10%20%10th90th$41$10.0$20.0$50.0$100.0$200.0

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
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $36.31 / $43.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $40.74 / $93.33
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $48.98 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $28.18 / $74.13
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $42.66 / $74.13
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $40.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $47.86 / $95.50
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $426.58