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Biopsy Of The Roof Of The Mouth

Georgia 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 $2,884 · 10th–90th $513$6,9180%10%10th90th$2,884Professionalmedian $166 · 10th–90th $110$3160%10%20%10th90th$166$10.0$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
$173.78
Median
$3,548.13
Typical High
$7,585.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$154.88
Typical High
$316.23
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$144.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$2,570.40
Typical High
$5,888.44
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$208.93
Typical High
$316.23
CareSource
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$144.54
Typical High
$537.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$181.97
Typical High
$338.84
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$177.83
Typical High
$309.03
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
United
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$2,137.96
Typical High
$5,011.87
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$158.49
Typical High
$288.40