80506

Pathology clinical consultation, additional 30 minutes

Medicare pricing data for 9 providers across 3 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Pathology clinical consultation, additional 30 minutes (HCPCS code 80506) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $43.02, but hospitals typically charge $68.11 — a 1.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.60

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $43.02, your out-of-pocket cost would be approximately $8.60. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$43.02
Average Hospital Charge
$68.11
Markup Ratio
1.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$68.11
Medicare Allowed$43.02
Medicare Payment$33.23

Hospitals charge 1.6x more than what Medicare allows for this procedure. Medicare actually pays $33.23 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Colorado$44$681886+3.0%
Texas$43$68112,501-0.2%
Maryland$42$93659-2.0%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber