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Surgical Exploration Of The Epididymis

Pennsylvania 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?

$479

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $479 for this service. The price depends on where it is billed: about $363 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$363$331 to $457
FacilityA hospital or hospital-owned outpatient department$2,692$1,585 to $5,370

How much rates vary

Facilitymedian $2,692 · 10th to 90th $661 to $8,318Professionalmedian $363 · 10th to 90th $316 to $708
$500$1K$2K$5K$10Kfacility $2,692professional $363

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
$316.23
Median
$363.08
Typical High
$707.95
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$6,165.95
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$457.09
Typical High
$660.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$426.58
Typical High
$676.08
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$562.34
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$1,737.80
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$457.09
Typical High
$707.95
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
$316.23
Median
$389.05
Typical High
$1,995.26
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$407.38
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$346.74
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$354.81
Typical High
$371.54
United
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$3,890.45
Typical High
$10,471.29
United
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$407.38
Typical High
$724.44

Where Pennsylvania 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.

Pennsylvania· 43rd of 51

$479

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.