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Biopsy Of The Roof Of The Mouth

Indiana 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 $6,607 · 10th–90th $240$10,4710%10%10th90th$6,607Professionalmedian $141 · 10th–90th $105$2290%10%10th90th$141$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$120.23
Median
$1,380.38
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$141.25
Typical High
$213.80
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,265.80
Median
$8,317.64
Typical High
$11,220.18
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$147.91
Typical High
$281.84
CareSource
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$112.20
Typical High
$125.89
CareSource
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$173.78
Typical High
$758.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$169.82
Typical High
$288.40
United
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$3,467.37
Typical High
$6,456.54
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$141.25
Typical High
$229.09