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Biopsy Of The Roof Of The Mouth

Colorado 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 $3,236 · 10th–90th $135$8,1280%5%10th90th$3,236Professionalmedian $148 · 10th–90th $107$2450%10%20%10th90th$148$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
$151.36
Median
$3,981.07
Typical High
$7,585.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$144.54
Typical High
$223.87
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$6,760.83
Typical High
$10,964.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$181.97
Typical High
$275.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$891.25
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$173.78
Typical High
$275.42
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$169.82
Typical High
$269.15
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$158.49
Typical High
$457.09
Select Health
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$208.93
Typical High
$323.59
Select Health
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$123.03
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$3,235.94
Typical High
$6,309.57
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$173.78
Typical High
$281.84