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Needle Biopsy Of The Epididymis

Ohio 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?

$240

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $240 for this service. The price depends on where it is billed: about $158 from a physician practice, and about $2,630 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 8 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$129 to $263
FacilityA hospital or hospital-owned outpatient department$2,630$1,445 to $4,786

How much rates vary

Facilitymedian $2,630 · 10th to 90th $417 to $10,715Professionalmedian $158 · 10th to 90th $115 to $2,455
$50$200$1K$5Kfacility $2,630professional $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
$239.88
Median
$2,818.38
Typical High
$12,022.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$158.49
Typical High
$8,912.51
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$2,187.76
Typical High
$7,943.28
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$158.49
Typical High
$331.13
CareSource
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$125.89
Typical High
$141.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$199.53
Typical High
$21,379.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$186.21
Typical High
$269.15
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$21,379.62
Median
$21,379.62
Typical High
$21,379.62
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$190.55
Typical High
$269.15
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$134.90
Typical High
$251.19
United
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$1,659.59
Typical High
$4,073.80
United
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$151.36
Typical High
$245.47

Where Ohio 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.

Ohio· 21st of 51

$240

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.