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Biopsy Of The Roof Of The Mouth

Montana 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 $204 · 10th–90th $145$3090%20%10th90th$204Professionalmedian $148 · 10th–90th $102$2570%20%10th90th$148$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
Professional
Modifier
Global
Typical Low
$100.00
Median
$138.04
Typical High
$208.93
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$234.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$181.97
Typical High
$446.68
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$251.19
Typical High
$275.42
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$251.19
Typical High
$275.42
Providence
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$186.21
Typical High
$323.59
Providence
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$223.87
Typical High
$371.54
United
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$3,162.28
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$204.17
Typical High
$281.84