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Biopsy Of The Roof Of The Mouth

Arkansas 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 Arkansas, July 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $138 from a physician practice, and about $1,175 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 4 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$138$115 to $166
FacilityA hospital or hospital-owned outpatient department$1,175$589 to $1,778

How much rates vary

Facilitymedian $1,175 · 10th to 90th $170 to $2,042Professionalmedian $138 · 10th to 90th $102 to $204
$100$200$500$1K$2K$5Kfacility $1,175professional $138

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
$134.90
Median
$794.33
Typical High
$1,862.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$134.90
Typical High
$181.97
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$1,412.54
Typical High
$1,949.84
BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$154.88
Typical High
$204.17
Cigna
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$363.08
Typical High
$776.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$169.82
Typical High
$263.03
United
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$1,445.44
Typical High
$4,365.16
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$147.91
Typical High
$245.47

Where Arkansas 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.

Arkansas· 36th 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.