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Biopsy Of The Roof Of The Mouth

Maryland 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 $447 · 10th–90th $98$1,4790%10%10th90th$447Professionalmedian $145 · 10th–90th $102$3240%10%10th90th$145$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$77.62
Median
$77.62
Typical High
$3,311.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$144.54
Typical High
$371.54
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$114.82
Typical High
$165.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$100.00
Typical High
$436.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$162.18
Typical High
$302.00
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$169.82
Typical High
$239.88
United
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$478.63
Typical High
$1,318.26
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$151.36
Typical High
$269.15
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$158.49
Typical High
$229.09