go back

Pennsylvania 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.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $40.74 / $128.82
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $48.98 / $48.98
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $53.70 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $75.86 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $30.90 / $70.79
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $72.44 / $93.33
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $57.54 / $109.65
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $48.98 / $50.12
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $43.65 / $141.25
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $89.13 / $95.50
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $51.29 / $117.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $50.12 / $75.86