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Biopsy Of The Roof Of The Mouth

Missouri 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 $1,479 · 10th–90th $135$4,6770%5%10th90th$1,479Professionalmedian $155 · 10th–90th $107$4070%10%10th90th$155$50.0$200.0$1.0K$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
$114.82
Median
$1,778.28
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$154.88
Typical High
$616.60
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$1,778.28
Typical High
$3,981.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$147.91
Typical High
$239.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$158.49
Typical High
$223.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$1,659.59
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$165.96
Typical High
$302.00
Medica
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$173.78
Typical High
$426.58
Medica
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$263.03
Typical High
$1,096.48
United
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,318.26
Typical High
$3,019.95
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$154.88
Typical High
$269.15