Prostate biopsy

Taking small tissue samples from the prostate to check for cancer.
Code 55700 · Surgery & procedures · statewide summary · negotiated in-network prices
Payers shown: CareSource
Prices shown: surgery centers and hospital outpatient departments
Doctor’s fee or facility fee? These are facility fees: what the insurer pays the hospital or surgery center itself. The doctors who treat you bill separately, on top of it.
Who is counted: CareSource lists clinicians individually: 96% of the 201,059 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs. CareSource’s files name 20,555 providers for this procedure; 1,080 are counted here: the clinicians whose specialty performs it — mostly Clinic/Center, Urology and Specialist — and the practices, clinics and hospitals. Insurers attach their whole fee schedule to every contracted provider, so the rest are clinicians listed at a price for something they never do; counting them would inflate the provider count and pull the typical price towards the fee schedule’s floor.
Not on this map: CareSource labels almost every price in its files as a facility ("institutional") price, office visits included. The amounts match what a doctor's visit normally costs, so read the doctor's-fee / facility-fee label on these pages with caution. CareSource publishes no prices for hospital stays in these files. Its files are for its Marketplace (individual) plans; plans for CareSource's own employees are published by UnitedHealthcare and are not included. Hospital stays: CareSource's files have no prices for whole hospital stays (the kind billed as one amount per stay), so there are no hospital-stay maps for it. It may pay hospitals by the day or as a share of their charges, which these maps cannot show.
StateProvidersNamed in filesOrganisationsZip codes Lowest25th pctMedian75th pctHighest
This is a statewide summary. Prices vary far more between towns and between practices than these medians suggest; zip-code and provider-level detail is not published here; this specific data can be requested here.