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New York 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 $54–$1410%20%40%10th90th$107Professionalmedian $76 · 10th–90th $39–$1820%10%20%10th90th$76$1.0$10.0$100.0$1.0K$10.0K$100.0K

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
$56.23 / $75.86 / $173.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $218.78
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $125.89 / $125.89
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $125.89 / $134.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $109.65 / $263.03
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $93.33
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $89.13 / $134.90
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $85.11 / $165.96
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $102.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $107.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $74.13 / $177.83
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $87.10 / $169.82