Biopsy of prostate gland
Medicare pricing data for 11,024 providers across 52 states
Prices vary significantly by location — from $122 in West Virginia to $460 in Maryland. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Biopsy of prostate gland (HCPCS code 55700) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $279.72, but hospitals typically charge $1,171 — a 4.2x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $279.72, your out-of-pocket cost would be approximately $55.94. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 4.2x more than what Medicare allows for this procedure. Medicare actually pays $215.76 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Maryland | $460 | $1,718 | 209 | 7,495 | +64.6% |
| Nebraska | $387 | $1,248 | 79 | 2,109 | +38.3% |
| Kentucky | $372 | $900 | 110 | 2,062 | +33.1% |
| Mississippi | $352 | $1,066 | 97 | 2,527 | +25.9% |
| Georgia | $349 | $1,282 | 334 | 5,943 | +24.6% |
| New Jersey | $339 | $2,518 | 412 | 5,755 | +21.1% |
| Colorado | $330 | $1,440 | 202 | 3,226 | +17.9% |
| Rhode Island | $325 | $738 | 37 | 475 | +16.1% |
| South Dakota | $324 | $1,172 | 27 | 1,045 | +15.7% |
| Virginia | $319 | $1,041 | 275 | 5,310 | +13.9% |
| Oregon | $308 | $1,109 | 146 | 1,901 | +10.2% |
| Tennessee | $308 | $1,056 | 236 | 5,099 | +10.0% |
| Pennsylvania | $303 | $1,168 | 502 | 8,131 | +8.5% |
| Florida | $302 | $1,471 | 898 | 12,261 | +8.1% |
| Kansas | $299 | $1,020 | 92 | 2,482 | +6.8% |
| Nevada | $297 | $939 | 68 | 1,014 | +6.3% |
| Arkansas | $290 | $841 | 73 | 1,780 | +3.5% |
| Hawaii | $283 | $1,050 | 30 | 302 | +1.2% |
| California | $279 | $1,181 | 995 | 13,235 | -0.1% |
| Alaska | $278 | $1,687 | 30 | 375 | -0.8% |
| Arizona | $274 | $1,077 | 261 | 4,256 | -2.2% |
| Texas | $268 | $1,455 | 782 | 10,051 | -4.2% |
| Ohio | $260 | $766 | 426 | 6,420 | -7.0% |
| South Carolina | $253 | $1,041 | 182 | 3,940 | -9.4% |
| Illinois | $252 | $1,000 | 432 | 6,772 | -9.9% |
| Missouri | $248 | $932 | 228 | 2,737 | -11.2% |
| New York | $242 | $1,073 | 697 | 9,385 | -13.3% |
| Puerto Rico | $238 | $344 | 59 | 152 | -15.1% |
| Washington | $231 | $659 | 215 | 3,098 | -17.3% |
| Massachusetts | $227 | $949 | 256 | 3,813 | -18.9% |
| Indiana | $226 | $1,986 | 283 | 3,781 | -19.3% |
| Iowa | $220 | $830 | 105 | 1,612 | -21.3% |
| Wisconsin | $218 | $1,569 | 203 | 2,175 | -21.9% |
| Alabama | $216 | $612 | 165 | 1,871 | -22.9% |
| Minnesota | $214 | $1,082 | 168 | 2,109 | -23.4% |
| Wyoming | $214 | $843 | 21 | 367 | -23.5% |
| Utah | $209 | $537 | 77 | 1,036 | -25.3% |
| Michigan | $208 | $656 | 340 | 3,502 | -25.6% |
| Connecticut | $208 | $1,104 | 131 | 1,213 | -25.7% |
| New Mexico | $205 | $612 | 41 | 478 | -26.6% |
| Delaware | $202 | $647 | 45 | 947 | -27.7% |
| North Carolina | $195 | $712 | 378 | 4,269 | -30.3% |
| District of Columbia | $194 | $682 | 28 | 428 | -30.7% |
| Oklahoma | $186 | $631 | 141 | 1,642 | -33.3% |
| Idaho | $186 | $472 | 52 | 670 | -33.6% |
| Louisiana | $180 | $715 | 206 | 2,107 | -35.8% |
| Montana | $172 | $446 | 46 | 1,012 | -38.5% |
| New Hampshire | $170 | $661 | 52 | 744 | -39.3% |
| Maine | $143 | $463 | 49 | 429 | -48.7% |
| North Dakota | $125 | $1,223 | 20 | 471 | -55.3% |
| Vermont | $123 | $329 | 22 | 298 | -56.2% |
| West Virginia | $122 | $520 | 49 | 571 | -56.3% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber