Outpatient prostate biopsy
What goes into a price?
Negotiated prices across insurers
Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.
Procedures included in this package
This list includes the services and fees bundled into the Outpatient prostate biopsy Standard Service Package (SSP RE005). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.
| Code | Code Type | Description |
|---|---|---|
| HCPCS J3010 | Facility Fee | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS 76942 | Professional Fee | Ultrasonic Needle Guidance with Imaging Supervision and Interpretation |
| HCPCS J0690 | Facility Fee | Intramuscular injection cefazolin sodium, 500mg |
| HCPCS J2405 | Facility Fee | Intramuscular injection of ondansetron hydrochloride, 1mg |
| HCPCS J2003 | Facility Fee | Injection, lidocaine hydrochloride, 1mg |
| HCPCS J1100 | Facility Fee | Intramuscular injection of 1mg dexamethasone sodium phosphate |
| HCPCS 55700 | Facility Fee | Needle/punch Biopsy of Prostate Gland Through Any Approach |
| HCPCS 88344 | Facility Fee | Immunoassay Detection of Antibodies in Tissue Sample, Multiplex per Specimen |
| HCPCS 76942 | Facility Fee | Ultrasonic Needle Guidance with Imaging Supervision and Interpretation |
| HCPCS 88305 | Facility Fee | Microscopic/gross-exam of surgical pathology biopsies/exam/resections |
| HCPCS 55700 | Professional Fee | Needle/punch Biopsy of Prostate Gland Through Any Approach |
| Revenue Code 250 | Facility Fee | Pharmacy (Also see 063X, an extension of 250X) - General |