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Biopsy Of The Roof Of The Mouth

Iowa 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 $2,239 · 10th–90th $158$6,4570%5%10%10th90th$2,239Professionalmedian $186 · 10th–90th $105$7080%10%10th90th$186$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
$245.47
Median
$3,388.44
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$165.96
Typical High
$707.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$275.42
Typical High
$436.52
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$213.80
Typical High
$446.68
Medica
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$245.47
Typical High
$3,630.78
Medica
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$295.12
Typical High
$1,096.48
Midlands
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$288.40
Typical High
$398.11
Midlands
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
Midlands
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$295.12
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$3,548.13
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$186.21
Typical High
$354.81
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$251.19
Typical High
$371.54