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Surgical Exploration Of The Epididymis

New York 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?

$912

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $912 for this service. The price depends on where it is billed: about $437 from a physician practice, and about $4,074 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$437$355 to $646
FacilityA hospital or hospital-owned outpatient department$4,074$2,570 to $6,166

How much rates vary

Facilitymedian $4,074 · 10th to 90th $550 to $9,120Professionalmedian $437 · 10th to 90th $309 to $1,072
$500$1K$2K$5K$10Kfacility $4,074professional $437

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
$467.74
Median
$3,090.30
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$467.74
Typical High
$1,318.26
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$4,786.30
Typical High
$9,120.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$371.54
Typical High
$912.01
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$1,258.93
Typical High
$4,073.80
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$3,801.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$630.96
Typical High
$1,584.89
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$416.87
Typical High
$1,230.27
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$478.63
Typical High
$676.08
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$489.78
Typical High
$776.25
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$501.19
Typical High
$1,023.29
United
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$3,981.07
Typical High
$9,549.93
United
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$478.63
Typical High
$1,174.90
Univera
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$478.63
Typical High
$1,071.52
Univera
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$478.63
Typical High
$933.25

Where New York 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 York· 10th of 51

$912

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.