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Biopsy Of The Roof Of The Mouth

Nebraska 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 $3,388 · 10th–90th $155$13,4900%5%10%10th90th$3,388Professionalmedian $158 · 10th–90th $102$3550%10%10th90th$158$50.0$200.0$1.0K$5.0K$20.0K

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
$2,187.76
Median
$4,365.16
Typical High
$14,454.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$154.88
Typical High
$354.81
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$4,677.35
Typical High
$9,120.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$190.55
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$275.42
Typical High
$478.63
Medica
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$177.83
Typical High
$338.84
Medica
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$316.23
Typical High
$1,096.48
Midlands
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$338.84
Typical High
$436.52
Midlands
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$275.42
Typical High
$346.74
United
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$2,344.23
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$218.78
Typical High
$354.81