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Surgical Exploration Of The Epididymis

New Jersey 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?

$490

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $490 for this service. The price depends on where it is billed: about $398 from a physician practice, and about $6,026 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$398$347 to $631
FacilityA hospital or hospital-owned outpatient department$6,026$4,365 to $8,511

How much rates vary

Facilitymedian $6,026 · 10th to 90th $2,570 to $10,965Professionalmedian $398 · 10th to 90th $316 to $4,266
$500$1K$2K$5K$10Kfacility $6,026professional $398

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
$2,290.87
Median
$5,888.44
Typical High
$10,964.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$398.11
Typical High
$5,888.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$489.78
Typical High
$954.99
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$478.63
Typical High
$630.96
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$7,244.36
Median
$11,481.54
Typical High
$17,378.01
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$407.38
Typical High
$933.25
United
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$6,165.95
Typical High
$10,964.78
United
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$371.54
Typical High
$758.58

Where New Jersey 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.

New Jersey· 42nd of 51

$490

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.