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Needle Biopsy of Muscle

North Carolina rates for HCPCS 20206

A provider inserts a needle through the skin and into a muscle to remove a small tissue sample for laboratory examination. This helps diagnose muscle diseases, inflammation, or other conditions affecting muscle tissue. It's a less invasive alternative to an open surgical muscle biopsy.

Rates data updated July 2026.

How much does Needle Biopsy of Muscle cost?

$916

Typical total for the visit. In North Carolina, July 2026.

Insurers have agreed to pay about $916 for this procedure. That total is two separate charges: $224 to the doctor who performs it, and $692 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$224$81.28 to $347
Facility feeThe hospital or surgery center$692$224 to $2,692

How much rates vary

Facilitymedian $692 · 10th to 90th $68 to $5,129Professionalmedian $224 · 10th to 90th $56 to $603
$50$100$200$500$1K$2K$5Kfacility $692professional $224

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
Aetna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$1,096.48
Typical High
$5,248.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$223.87
Typical High
$562.34
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$74.13
Typical High
$398.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$645.65
BCBS
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$309.03
Typical High
$616.60
Cigna
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$398.11
Typical High
$1,288.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$186.21
Typical High
$457.09
Medcost
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$562.34
Medcost
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$199.53
Typical High
$426.58
United
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$3,467.37
Typical High
$7,079.46
United
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$169.82
Typical High
$389.05
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$19,498.45
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,778.28

Where North Carolina sits

The same service costs 12.1 times more in Indiana than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

North Carolina· 39th of 51

$916

$224 physician + $692 facility

IN $5,056DE $416

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.