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Surgical Exploration Of The Epididymis

Maine rates for HCPCS 54865

A surgical look at the epididymis, the coiled tube behind the testicle where sperm mature, through a small cut in the scrotum. A tissue sample may be taken during the same operation if something abnormal is found.

Rates data updated October 2026.

How much does Surgical Exploration Of The Epididymis cost?

$501

Typical negotiated rate. In Maine, October 2026.

Insurers have agreed to pay about $501 for this service. The price depends on where it is billed: about $501 from a physician practice, and about $1,778 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$501$398 to $617
FacilityA hospital or hospital-owned outpatient department$1,778$1,698 to $2,344

How much rates vary

Facilitymedian $1,778 · 10th to 90th $537 to $3,311Professionalmedian $501 · 10th to 90th $355 to $692
$500$1K$2K$5Kfacility $1,778professional $501

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$354.81
Median
$354.81
Typical High
$660.69
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$338.84
Median
$512.86
Typical High
$691.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$537.03
Median
$1,905.46
Typical High
$3,090.30
Cigna
Setting
Professional
Modifier
None
Typical Low
$467.74
Median
$489.78
Typical High
$812.83
Harvard Pilgrim
Setting
Facility
Modifier
None
Typical Low
$1,071.52
Median
$1,778.28
Typical High
$3,311.31
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$416.87
Median
$524.81
Typical High
$691.83
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$354.81
Median
$354.81
Typical High
$660.69
United
Setting
Facility
Modifier
None
Typical Low
$1,071.52
Median
$1,778.28
Typical High
$3,311.31
United
Setting
Professional
Modifier
None
Typical Low
$363.08
Median
$562.34
Typical High
$724.44
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$251.19
Median
$251.19
Typical High
$251.19

Where Maine sits

The same service costs 6.2 times more in Alaska than in Utah. 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.

Maine· 35th of 51

$501

AK $1,905UT $309

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.