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Biopsy Of The Roof Of The Mouth

Louisiana 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 Louisiana, July 2026.

Insurers have agreed to pay about $158 for this service. The price depends on where it is billed: about $148 from a physician practice, and about $1,349 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$148$123 to $195
FacilityA hospital or hospital-owned outpatient department$1,349$871 to $2,692

How much rates vary

Facilitymedian $1,349 · 10th to 90th $200 to $3,467Professionalmedian $148 · 10th to 90th $102 to $234
$50$100$200$500$1K$2K$5Kfacility $1,349professional $148

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
$199.53
Median
$1,288.25
Typical High
$3,548.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$147.91
Typical High
$234.42
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$144.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$2,187.76
Typical High
$3,090.30
BCBS
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$177.83
Typical High
$229.09
Christus
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$43.65
Typical High
$89.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$489.78
Typical High
$575.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$177.83
Typical High
$331.13
United
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$1,698.24
Typical High
$4,168.69
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$144.54
Typical High
$239.88

Where Louisiana 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.

Louisiana· 20th 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.