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Prostate Biopsy

Pennsylvania 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?

$251

Typical physician fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $251 for this service. Most negotiated rates run $214 to $263.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $269 · 10th to 90th $126 to $417Professionalmedian $251 · 10th to 90th $126 to $324
$100.0$200.0$500.0$1.0K$2.0K$5.0Kfacility $269professional $251

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$245.47
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$251.19
Typical High
$346.74
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$338.84
Typical High
$6,309.57
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$218.78
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$234.42
Typical High
$302.00
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$234.42
Typical High
$302.00

Where Pennsylvania 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.

Pennsylvania $251 · 43rd 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.