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Biopsy Of The Roof Of The Mouth

Alabama 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.

How much does Biopsy Of The Roof Of The Mouth cost?

$148

Typical negotiated rate. In Alabama, July 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $148 from a physician practice, and about $1,445 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$148$115 to $195
FacilityA hospital or hospital-owned outpatient department$1,445$1,023 to $1,862

How much rates vary

Facilitymedian $1,445 · 10th to 90th $617 to $2,455Professionalmedian $148 · 10th to 90th $102 to $288
$100$200$500$1K$2K$5Kfacility $1,445professional $148

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
$562.34
Median
$954.99
Typical High
$2,398.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$147.91
Typical High
$288.40
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$1,513.56
Typical High
$2,041.74
BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$177.83
Typical High
$229.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$169.82
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$1,778.28
Typical High
$3,162.28
United
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$138.04
Typical High
$229.09

Where Alabama sits

The same service costs 2.1 times more in Minnesota than in Hawaii. 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.

Alabama· 40th of 51

$148

MN $282HI $135

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.