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Biopsy Of The Roof Of The Mouth

Idaho 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 $224 · 10th–90th $129$3,7150%5%10%10th90th$224Professionalmedian $166 · 10th–90th $110$2950%10%10th90th$166$50.0$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
$1,412.54
Median
$4,466.84
Typical High
$7,079.46
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$151.36
Typical High
$316.23
BCBS
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$1,513.56
Typical High
$3,981.07
BCBS
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$223.87
Typical High
$288.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$186.21
Typical High
$281.84
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$186.21
Typical High
$354.81
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$218.78
Typical High
$302.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$138.04
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$3,467.37
Typical High
$5,011.87
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$234.42
Typical High
$295.12
Select Health
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$977.24
Typical High
$2,344.23
Select Health
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$138.04
Typical High
$208.93
United
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$6,165.95
Typical High
$7,762.47
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$177.83
Typical High
$275.42