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Biopsy Of The Roof Of The Mouth

Delaware 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 $2,630 · 10th–90th $417$3,2360%50%10th90th$2,630Professionalmedian $138 · 10th–90th $102$2340%10%10th90th$138$100.0$200.0$500.0$1.0K$2.0K$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
$2,630.27
Median
$2,630.27
Typical High
$3,235.94
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$134.90
Typical High
$234.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$1,412.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$158.49
Typical High
$263.03
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$114.82
Typical High
$1,318.26
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$138.04
Typical High
$218.78