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South Dakota 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 $59 · 10th–90th $51–$830%10%20%10th90th$59Professionalmedian $49 · 10th–90th $35–$1020%10%20%10th90th$49$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $43.65 / $48.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $70.79 / $117.49
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $58.88 / $83.18
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $102.33 / $331.13
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $93.33 / $102.33
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $89.13 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $32.36 / $114.82
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $104.71 / $114.82