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Prostate Biopsy

North Carolina rates for HCPCS 55700

Takes small samples of tissue from the prostate with a needle so they can be examined under a microscope. Several samples are usually taken during the same visit. It is done when a blood test or a physical examination suggests a possible problem in the prostate.

Rates data updated July 2026.

How much does Prostate Biopsy cost?

$1,995

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $1,995 for this service. The price depends on where it is billed: about $1,738 from a physician practice, and about $3,548 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,738$1,738 to $1,995
FacilityA hospital or hospital-owned outpatient department$3,548$2,042 to $5,495

How much rates vary

Facilitymedian $3,548 · 10th to 90th $1,738 to $7,079Professionalmedian $1,738 · 10th to 90th $1,738 to $1,995
$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0Kfacility $3,548professional $1,738

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$331.13
Medcost
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$630.96
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$3,715.35
United
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$2,691.53
Typical High
$4,168.69
United
Setting
Professional
Modifier
Global
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$2,089.30
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$5,495.41
Median
$5,495.41
Typical High
$28,840.32
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$1,995.26

Where North Carolina sits

The same service costs 234.4 times more in Indiana than in New Mexico. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

North Carolina $1,995 · 15th of 50
IN $7,762NM $33.11

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.