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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.

Facilitymedian $1,660 · 10th–90th $145$7,4130%5%10th90th$1,660Professionalmedian $151 · 10th–90th $107$2340%20%10th90th$151$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
$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