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Virginia 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 $52 · 10th–90th $38–$890%10%20%10th90th$52Professionalmedian $39 · 10th–90th $25–$710%10%10th90th$39$0.5$2.0$10.0$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $39.81 / $61.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $21.38 / $42.66
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $44.67 / $51.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $28.84 / $81.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $61.66 / $70.79
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $48.98 / $83.18
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $40.74
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $52.48 / $89.13
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $58.88 / $97.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $51.29 / $102.33