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Needle Biopsy of Muscle

New Jersey 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?

$5,005

Typical total for the visit. In New Jersey, July 2026.

Insurers have agreed to pay about $5,005 for this procedure. That total is two separate charges: $219 to the doctor who performs it, and $4,786 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$219$58.88 to $288
Facility feeThe hospital or surgery center$4,786$3,090 to $6,457

How much rates vary

Facilitymedian $4,786 · 10th to 90th $282 to $10,233Professionalmedian $219 · 10th to 90th $52 to $724
$50$200$1K$5Kfacility $4,786professional $219

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
$281.84
Median
$4,677.35
Typical High
$10,000.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$213.80
Typical High
$1,096.48
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$48.98
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$8,317.64
Typical High
$15,135.61
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$177.83
Typical High
$1,047.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$177.83
Typical High
$575.44
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$263.03
Typical High
$354.81
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$5,248.07
Typical High
$8,317.64
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$239.88
Typical High
$588.84
United
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$5,128.61
Typical High
$8,511.38
United
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$173.78
Typical High
$467.74

Where New Jersey 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

New Jersey· 2nd of 51

$5,005

$219 physician + $4,786 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.