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Biopsy Of The Roof Of The Mouth

North Dakota 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.

How much does Biopsy Of The Roof Of The Mouth cost?

$178

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $178 for this service. The price depends on where it is billed: about $186 from a physician practice, and about $148 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$186$138 to $282
FacilityA hospital or hospital-owned outpatient department$148$107 to $224

How much rates vary

Facilitymedian $148 · 10th to 90th $105 to $1,995Professionalmedian $186 · 10th to 90th $105 to $331
$100$200$500$1K$2K$5Kfacility $148professional $186

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$144.54
Typical High
$1,995.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$144.54
Typical High
$234.42
BCBS
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$281.84
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$251.19
Typical High
$380.19
Medica
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$181.97
Typical High
$331.13
Medica
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$257.04
Typical High
$1,096.48
United
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$1,819.70
Typical High
$3,090.30
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$186.21
Typical High
$302.00

Where North Dakota sits

The same service costs 2.1 times more in Minnesota than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

North Dakota· 11th of 51

$178

MN $282HI $135

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.