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Needle Biopsy Of The Epididymis

North Carolina 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?

$209

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $209 for this service. The price depends on where it is billed: about $186 from a physician practice, and about $912 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$186$135 to $245
FacilityA hospital or hospital-owned outpatient department$912$209 to $4,266

How much rates vary

Facilitymedian $912 · 10th to 90th $123 to $6,457Professionalmedian $186 · 10th to 90th $123 to $407
$100$200$500$1K$2K$5K$10Kfacility $912professional $186

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
$123.03
Median
$1,380.38
Typical High
$7,585.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$141.25
Typical High
$416.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$223.87
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$208.93
Typical High
$323.59
Medcost
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$177.83
Typical High
$331.13
Medcost
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$2,344.23
Typical High
$4,365.16
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$151.36
Typical High
$288.40
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$19,498.45
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,995.26
Typical High
$1,995.26

Where North Carolina 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.

North Carolina· 28th of 51

$209

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.