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Surgical Exploration Of The Epididymis

North Carolina 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 July 2026.

How much does Surgical Exploration Of The Epididymis cost?

$525

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $525 for this service. The price depends on where it is billed: about $501 from a physician practice, and about $1,349 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$501$380 to $708
FacilityA hospital or hospital-owned outpatient department$1,349$562 to $5,248

How much rates vary

Facilitymedian $1,349 · 10th to 90th $347 to $8,710Professionalmedian $501 · 10th to 90th $347 to $1,023
$500$1K$2K$5K$10Kfacility $1,349professional $501

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
$346.74
Median
$1,380.38
Typical High
$7,585.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$416.87
Typical High
$1,122.02
BCBS
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$524.81
Typical High
$977.24
Cigna
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$549.54
Typical High
$912.01
Medcost
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$478.63
Typical High
$724.44
Medcost
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$912.01
United
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$6,918.31
Typical High
$12,882.50
United
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$407.38
Typical High
$831.76
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$9,772.37
Median
$9,772.37
Typical High
$19,498.45
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$2,630.27
Median
$3,019.95
Typical High
$3,019.95

Where North Carolina sits

The same service costs 8.3 times more in Colorado 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· 37th of 51

$525

CO $3,236DE $389

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.