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New Jersey 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 $13,804 · 10th–90th $282–$19,4980%20%40%10th90th$13,804Professionalmedian $42 · 10th–90th $29–$810%20%10th90th$42$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $40.74 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $42.66 / $81.28
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $53.70 / $77.62
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $13,803.84 / $19,498.45
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $57.54 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $38.90 / $67.61