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Pathologist Consultation On A Complex Lab Result

Virginia 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?

$40.74

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $40.74 for this service. Most negotiated rates run $35.48 to $44.67.

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 8 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $52 · 10th to 90th $38 to $89Professionalmedian $41 · 10th to 90th $21 to $62
$20$50$100facility $52professional $41

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$40.74
Typical High
$44.67
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$21.38
Typical High
$37.15
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$44.67
Typical High
$51.29
Cigna
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$28.84
Typical High
$83.18
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$61.66
Typical High
$70.79
Medcost
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$48.98
Typical High
$83.18
Medcost
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$40.74
Typical High
$40.74
Sentara
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$52.48
Typical High
$89.13
Sentara
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$58.88
Typical High
$97.72
United
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$51.29
Typical High
$102.33

Where Virginia 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.

Virginia· 37th of 51

$40.74

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.