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Pathologist Consultation On A Complex Lab Result

New Jersey 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?

$40.74

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $40.74 for this service. Most negotiated rates run $33.88 to $47.86.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $16,218 · 10th to 90th $13,804 to $16,218Professionalmedian $41 · 10th to 90th $30 to $69
$20$100$500$2K$10Kfacility $16,218professional $41

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$40.74
Typical High
$48.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$46.77
Typical High
$83.18
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$53.70
Typical High
$74.13
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$13,803.84
Median
$16,218.10
Typical High
$16,218.10
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$57.54
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$36.31
Typical High
$67.61

Where New Jersey 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.

New Jersey· 39th of 51

$40.74

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.