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Needle Biopsy Of The Epididymis

New Jersey 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?

$166

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $166 for this service. The price depends on where it is billed: about $151 from a physician practice, and about $5,888 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 5 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$129 to $229
FacilityA hospital or hospital-owned outpatient department$5,888$3,981 to $7,762

How much rates vary

Facilitymedian $5,888 · 10th to 90th $2,291 to $10,715Professionalmedian $151 · 10th to 90th $110 to $4,266
$100$200$500$1K$2K$5K$10Kfacility $5,888professional $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
$2,570.40
Median
$5,888.44
Typical High
$10,964.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$151.36
Typical High
$5,888.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$194.98
Typical High
$380.19
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$158.49
Typical High
$208.93
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,388.44
Median
$5,495.41
Typical High
$8,317.64
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$141.25
Typical High
$331.13
United
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$3,467.37
Typical High
$6,918.31
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$131.83
Typical High
$263.03

Where New Jersey 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.

New Jersey· 43rd of 51

$166

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.