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Biopsy Of The Roof Of The Mouth

Michigan 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 $1,514 · 10th–90th $138$5,6230%10%10th90th$1,514Professionalmedian $145 · 10th–90th $102$2090%10%10th90th$145$20.0$100.0$500.0$2.0K$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
$138.04
Median
$1,513.56
Typical High
$6,606.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$138.04
Typical High
$181.97
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
BCBS
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$158.49
Typical High
$208.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$154.88
Typical High
$288.40
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$398.11
Typical High
$4,897.79
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$151.36
Typical High
$245.47
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$407.38
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$2,570.40
Typical High
$6,025.60
United
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$158.49
Typical High
$239.88