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Wisconsin 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 $79 · 10th–90th $42–$1860%10%10th90th$79Professionalmedian $62 · 10th–90th $40–$1780%10%10th90th$62$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$39.81 / $48.98 / $74.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $144.54 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $186.21 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $54.95 / $138.04
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $61.66 / $147.91
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $138.04 / $158.49
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $61.66 / $147.91
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $74.13 / $331.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $58.88 / $85.11
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $74.13 / $83.18
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $112.20 / $151.36
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $295.12
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $74.13 / $331.13
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $109.65
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $269.15 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $51.29 / $144.54