go back

Needle Biopsy Of The Epididymis

Pennsylvania 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 Pennsylvania, July 2026.

Insurers have agreed to pay about $166 for this service. The price depends on where it is billed: about $135 from a physician practice, and about $2,692 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 9 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$135$115 to $162
FacilityA hospital or hospital-owned outpatient department$2,692$1,514 to $5,370

How much rates vary

Facilitymedian $2,692 · 10th to 90th $661 to $8,318Professionalmedian $135 · 10th to 90th $112 to $316
$100$200$500$1K$2K$5K$10Kfacility $2,692professional $135

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
$660.69
Median
$2,691.53
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$125.89
Typical High
$660.69
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$2,570.40
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$162.18
Typical High
$234.42
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$162.18
Typical High
$245.47
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$186.21
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$158.49
Typical High
$257.04
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$2,398.83
Typical High
$8,317.64
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$141.25
Typical High
$1,584.89
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$363.08
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$1,096.48
Typical High
$2,238.72
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$120.23
Typical High
$125.89
United
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$2,187.76
Typical High
$5,248.07
United
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$151.36
Typical High
$269.15

Where Pennsylvania 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.

Pennsylvania· 42nd 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.