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Massachusetts rates for HCPCS 80505

Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making. When using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.

Facilitymedian $107 · 10th–90th $83–$2140%10%20%10th90th$107Professionalmedian $91 · 10th–90th $66–$2190%10%10th90th$91$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $77.62 / $245.47
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $112.20 / $295.12
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $128.82 / $213.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $173.78 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $79.43 / $165.96
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $100.00 / $151.36
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $131.83 / $199.53
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $102.33 / $117.49
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $112.20 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $56.23 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $100.00 / $213.80