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New York 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 $58 · 10th–90th $28–$790%20%40%10th90th$58Professionalmedian $40 · 10th–90th $21–$1050%10%20%10th90th$40$1.0$10.0$100.0$1.0K$10.0K$100.0K

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
$28.84 / $40.74 / $104.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $21.38 / $120.23
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $67.61 / $67.61
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $67.61 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $58.88 / $144.54
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $47.86 / $74.13
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $46.77 / $91.20
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $57.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $57.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $39.81 / $97.72
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $48.98 / $91.20