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Needle Biopsy of the Penis

Montana rates for HCPCS 54100

This procedure uses a needle to remove a small sample of tissue from the penis for examination under a microscope. It may be used to evaluate a lump, area of hardening, or other abnormal finding, helping determine whether it is benign or requires further treatment. The sample provides information about the type of tissue change that is present.

Rates data updated July 2026.

How much does Needle Biopsy of the Penis cost?

$214

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $214 for this service. The price depends on where it is billed: about $209 from a physician practice, and about $324 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$209$155 to $229
FacilityA hospital or hospital-owned outpatient department$324$214 to $355

How much rates vary

Facilitymedian $324 · 10th to 90th $209 to $407Professionalmedian $209 · 10th to 90th $120 to $407
$100.0$1.0K$10.0K$100.0Kfacility $324professional $209

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$208.93
Typical High
$660.69
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$323.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$331.13
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$331.13
Typical High
$380.19
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$331.13
Typical High
$380.19
Providence
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$190.55
Typical High
$346.74
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$194.98
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$3,388.44
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$467.74

Where Montana sits

The same service costs 6.2 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Montana $214 · 41st of 51
HI $1,148DE $186

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.