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Prostate Biopsy

Illinois rates for HCPCS 55700

Takes small samples of tissue from the prostate with a needle so they can be examined under a microscope. Several samples are usually taken during the same visit. It is done when a blood test or a physical examination suggests a possible problem in the prostate.

Rates data updated July 2026.

How much does Prostate Biopsy cost?

$347

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $347 for this service. The price depends on where it is billed: about $339 from a physician practice, and about $1,905 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$339$214 to $447
FacilityA hospital or hospital-owned outpatient department$1,905$1,479 to $2,951

How much rates vary

Facilitymedian $1,905 · 10th to 90th $724 to $3,802Professionalmedian $339 · 10th to 90th $138 to $832
$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0Kfacility $1,905professional $339

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
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$239.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$1,905.46
Typical High
$3,630.78
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$346.74
Typical High
$870.96
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$162.18
Typical High
$323.59
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$2,137.96
Typical High
$4,570.88
United
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$416.87
Typical High
$489.78

Where Illinois sits

The same service costs 234.4 times more in Indiana than in New Mexico. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Illinois $347 · 38th of 50
IN $7,762NM $33.11

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.