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Biopsy Of The Roof Of The Mouth

Connecticut 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 $4,677 · 10th–90th $2,291$8,5110%10%10th90th$4,677Professionalmedian $155 · 10th–90th $105$3550%10%10th90th$155$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
$2,290.87
Median
$4,677.35
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$147.91
Typical High
$323.59
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$4,365.16
Typical High
$10,964.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$245.47
Typical High
$371.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$234.42
Typical High
$758.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$204.17
Typical High
$398.11
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$245.47
Typical High
$309.03
Health New England
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$275.42
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$5,495.41
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$199.53
Typical High
$407.38