go back

Biopsy Of The Roof Of The Mouth

Maine 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 $871 · 10th–90th $457$3,1620%20%10th90th$871Professionalmedian $178 · 10th–90th $117$3390%10%10th90th$178$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$870.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$141.25
Typical High
$177.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$177.83
Typical High
$309.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$190.55
Typical High
$354.81
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$218.78
Typical High
$398.11
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$151.36
Typical High
$213.80
United
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$3,162.28
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$186.21
Typical High
$338.84