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Needle Biopsy Of The Epididymis

Massachusetts 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?

$204

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $204 for this service. The price depends on where it is billed: about $158 from a physician practice, and about $2,188 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 7 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$158$135 to $263
FacilityA hospital or hospital-owned outpatient department$2,188$1,000 to $3,311

How much rates vary

Facilitymedian $2,188 · 10th to 90th $126 to $4,467Professionalmedian $158 · 10th to 90th $115 to $372
$100$200$500$1K$2K$5K$10Kfacility $2,188professional $158

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
$1,000.00
Median
$2,238.72
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$138.04
Typical High
$416.87
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$2,884.03
Typical High
$19,498.45
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$177.83
Typical High
$1,995.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$234.42
Typical High
$416.87
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$144.54
Typical High
$3,311.31
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$120.23
Typical High
$181.97
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$2,511.89
Typical High
$7,079.46
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$213.80
Typical High
$346.74
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$2,884.03
Typical High
$19,498.45
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$177.83
Typical High
$1,995.26
United
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$2,454.71
Typical High
$6,025.60
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$223.87
Typical High
$436.52

Where Massachusetts 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.

Massachusetts· 29th of 51

$204

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.