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Biopsy Of The Roof Of The Mouth

Arizona 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 $1,862 · 10th–90th $126$5,6230%5%10%10th90th$1,862Professionalmedian $145 · 10th–90th $102$2880%10%10th90th$145$50.0$200.0$1.0K$5.0K

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
$1,445.44
Median
$3,715.35
Typical High
$6,606.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$144.54
Typical High
$281.84
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$52.48
Typical High
$141.25
BCBS
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$2,290.87
Typical High
$4,466.84
BCBS
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$177.83
Typical High
$323.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$104.71
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$154.88
Typical High
$302.00
Medica
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$151.36
Typical High
$549.54
Medica
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$204.17
Typical High
$1,096.48
United
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$1,659.59
Typical High
$4,677.35
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$138.04
Typical High
$245.47