CPT 80055: Obstetric Laboratory Panel
Commercial payers pay $68 on average nationally for this procedure.
CPT code 80055 describes an obstetric laboratory panel performed by a laboratory analyst that includes a complete blood count with differential, hepatitis B surface antigen, rubella antibody, qualitative non-treponemal syphilis test, red blood cell antibody screen, ABO blood typing, and Rh typing; the service type is a comprehensive prenatal infectious disease and blood-typing screening panel typically performed in an outpatient laboratory or hospital clinical laboratory setting and ordered as part of routine prenatal care.
Customize your policy alerts
Sign up for cpt 80055 policy alerts
Get alerted when payer policies referencing 80055 are released or updated.
Monitor payer policy activity
National Reimbursement Benchmarks
BUCA’s average commercial rate for CPT 80055 sits at $68.30, positioning it near the middle of the payer mix. Blue Cross Blue Shield shows the highest dispersion with a P75–P25 range of $43.95 ($108.40 − $64.50), indicating a wide distribution of contracted rates. Cigna’s interquartile spread is $39.0 ($66.00 − $27.10), while Aetna’s spread is $13.00 ($45.00 − $31.00). UnitedHealth Group is the tightest among the listed payers with a P75–P25 range of $27.80 ($47.80 − $21.00), suggesting more consistency across commercial contracts for this code.
Looking at central tendency, Blue Cross Blue Shield and Cigna have higher mean and median positions relative to BUCA’s average, while Aetna and UnitedHealth Group report lower central values. Extreme maximums are notable for Blue Cross Blue Shield ($264.50) and Cigna ($159.00), which widen potential upside compared with BUCA’s average of $68.30. The combined picture is one of moderate central clustering around BUCA with pockets of significant upward variability driven primarily by Blue Cross Blue Shield and Cigna.