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Biopsy Of The Roof Of The Mouth

Washington, DC 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 $178$6,6070%10%10th90th$1,862Professionalmedian $138 · 10th–90th $110$1950%10%10th90th$138$100.0$500.0$2.0K$10.0K

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
$177.83
Median
$1,862.09
Typical High
$4,073.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$131.83
Typical High
$177.83
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$123.03
Typical High
$1,698.24
Cigna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$162.18
Typical High
$407.38
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$169.82
Typical High
$309.03
United
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$3,162.28
Typical High
$26,302.68
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$151.36
Typical High
$309.03