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Biopsy Of The Roof Of The Mouth

Kansas 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.

How much does Biopsy Of The Roof Of The Mouth cost?

$158

Typical negotiated rate. In Kansas, July 2026.

Insurers have agreed to pay about $158 for this service. The price depends on where it is billed: about $151 from a physician practice, and about $1,660 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$151$135 to $204
FacilityA hospital or hospital-owned outpatient department$1,660$219 to $4,467

How much rates vary

Facilitymedian $1,660 · 10th to 90th $145 to $7,413Professionalmedian $151 · 10th to 90th $107 to $234
$100$200$500$1K$2K$5K$10Kfacility $1,660professional $151

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$3,548.13
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$144.54
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$144.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$295.12
Typical High
$416.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$204.17
Cigna
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$794.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$165.96
Typical High
$309.03
Medica
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$169.82
Typical High
$1,148.15
Medica
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$229.09
Typical High
$1,096.48
United
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$1,174.90
Typical High
$3,162.28
United
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$151.36
Typical High
$234.42

Where Kansas sits

The same service costs 2.1 times more in Minnesota than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Kansas· 19th of 51

$158

MN $282HI $135

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.