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Biopsy Of The Roof Of The Mouth

New Hampshire 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?

$182

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $182 for this service. The price depends on where it is billed: about $182 from a physician practice, and about $1,698 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 7 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$182$141 to $240
FacilityA hospital or hospital-owned outpatient department$1,698$525 to $3,020

How much rates vary

Facilitymedian $1,698 · 10th to 90th $100 to $8,913Professionalmedian $182 · 10th to 90th $117 to $316
$20$100$500$2K$10Kfacility $1,698professional $182

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
$275.42
Median
$524.81
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$141.25
Typical High
$190.55
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,737.80
Typical High
$3,019.95
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$177.83
Typical High
$275.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$1,348.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$208.93
Typical High
$389.05
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$3,890.45
Typical High
$8,709.64
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$354.81
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$3,890.45
Typical High
$8,709.64
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$208.93
Typical High
$398.11
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$14.79
Median
$16.60
Typical High
$181.97

Where New Hampshire 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.

New Hampshire· 7th of 51

$182

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.