search again

Biopsy Of The Roof Of The Mouth

Nationwide rates for HCPCS 42100

Takes a small piece of tissue from the roof of the mouth or from the uvula, the flap hanging at the back of the throat, so it can be examined under a microscope. Only a sample is taken and the rest of the area is left in place. It is done to find out what is behind a patch, sore, swelling or growth that has not settled on its own.

Rates data updated July 2026.

Facilitymedian $1,905 · 10th–90th $135$7,7620%10%10th90th$1,905Professionalmedian $155 · 10th–90th $105$3390%20%40%10th90th$155$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$2,570.40
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$147.91
Typical High
$288.40
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$4,365.16
Typical High
$10,232.93
BCBS
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$158.49
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$323.59
Typical High
$1,202.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$177.83
Typical High
$380.19
United
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$2,454.71
Typical High
$5,888.44
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$158.49
Typical High
$302.00