go back

Biopsy Of The Roof Of The Mouth

Massachusetts 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 $1,000 · 10th–90th $132$3,7150%10%10th90th$1,000Professionalmedian $166 · 10th–90th $107$3980%10%20%10th90th$166$1.0$10.0$100.0$1.0K$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
$158.49
Median
$2,187.76
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$147.91
Typical High
$371.54
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$1,258.93
Typical High
$4,677.35
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$194.98
Typical High
$1,047.13
BCBS
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$302.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$302.00
Typical High
$954.99
Cigna
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$446.68
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$204.17
Typical High
$426.58
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$147.91
Typical High
$3,311.31
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$204.17
Typical High
$316.23
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$3,162.28
Typical High
$8,511.38
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$204.17
Typical High
$380.19
Health New England
Setting
Facility
Modifier
Global
Typical Low
$0.85
Median
$0.85
Typical High
$2,454.71
Health New England
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$1,258.93
Typical High
$4,677.35
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$194.98
Typical High
$1,047.13
United
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$2,818.38
Typical High
$6,918.31
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$213.80
Typical High
$398.11