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Biopsy Of The Roof Of The Mouth

California 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 $3,802 · 10th–90th $170$12,0230%5%10%10th90th$3,802Professionalmedian $155 · 10th–90th $102$5890%10%10th90th$155$50.0$200.0$1.0K$5.0K$20.0K

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
$1,071.52
Median
$5,248.07
Typical High
$16,982.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$154.88
Typical High
$630.96
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$4,466.84
Typical High
$12,882.50
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$154.88
Typical High
$302.00
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$3,162.28
Typical High
$6,456.54
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$151.36
Typical High
$309.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$309.03
Typical High
$891.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$177.83
Typical High
$338.84
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$123.03
Typical High
$229.09
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$158.49
Typical High
$295.12
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$56.23
Typical High
$3,890.45
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,230.27
Typical High
$1,230.27
Molina
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$204.17
Optum
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Providence
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$165.96
Typical High
$275.42
Providence
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$181.97
Typical High
$371.54
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$489.78
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$100.00
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$4,073.80
Typical High
$9,549.93
United
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$141.25
Typical High
$275.42