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Biopsy Of The Roof Of The Mouth

Florida 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 $3,631 · 10th–90th $457$10,7150%5%10%10th90th$3,631Professionalmedian $138 · 10th–90th $100$2450%20%10th90th$138$1.0$5.0$20.0$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
$380.19
Median
$3,235.94
Typical High
$10,964.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$141.25
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$144.54
Typical High
$177.83
AvMed
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$2,818.38
Typical High
$11,220.18
AvMed
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$162.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$173.78
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$165.96
Typical High
$309.03
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$4,786.30
Typical High
$9,549.93
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$125.89
Typical High
$177.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$85.11
Typical High
$177.83
United
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$3,090.30
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$134.90
Typical High
$245.47
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$112.20
Typical High
$154.88