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Needle Biopsy Of The Epididymis

Illinois rates for HCPCS 54800

A small tissue sample is taken with a needle from the epididymis, the coiled tube behind the testicle that stores and carries sperm. The sample is examined under a microscope, usually as part of investigating infertility or a lump.

Rates data updated July 2026.

How much does Needle Biopsy Of The Epididymis cost?

$245

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $245 for this service. The price depends on where it is billed: about $151 from a physician practice, and about $1,445 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$151$126 to $240
FacilityA hospital or hospital-owned outpatient department$1,445$851 to $3,236

How much rates vary

Facilitymedian $1,445 · 10th to 90th $240 to $5,370Professionalmedian $151 · 10th to 90th $123 to $417
$100$200$500$1K$2K$5K$10Kfacility $1,445professional $151

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
Facility
Modifier
Global
Typical Low
$239.88
Median
$1,380.38
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$138.04
Typical High
$380.19
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$2,398.83
Typical High
$3,162.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$177.83
Typical High
$295.12
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$213.80
Typical High
$602.56
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$158.49
Typical High
$169.82
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$1,412.54
Typical High
$3,981.07
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$173.78
Typical High
$302.00

Where Illinois sits

The same service costs 22.9 times more in California than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 19th of 51

$245

CA $3,162DE $138

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.