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Pathologist Consultation On A Complex Lab Result

South Dakota 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?

$74.13

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $74.13 for this service. Most negotiated rates run $38.90 to $93.33.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $59 · 10th to 90th $51 to $83Professionalmedian $76 · 10th to 90th $35 to $102
$50$100$200facility $59professional $76

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
$35.48
Median
$35.48
Typical High
$38.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$70.79
Typical High
$117.49
Medica
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$58.88
Typical High
$83.18
Medica
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$102.33
Typical High
$331.13
Midlands
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$93.33
Typical High
$102.33
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$89.13
Typical High
$102.33
United
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$32.36
Typical High
$114.82
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$91.20
Typical High
$114.82

Where South Dakota 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.

South Dakota· 6th of 51

$74.13

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.