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Biopsy Of The Roof Of The Mouth

Nevada 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?

$148

Typical negotiated rate. In Nevada, July 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $145 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 6 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$145$115 to $174
FacilityA hospital or hospital-owned outpatient department$1,698$155 to $3,890

How much rates vary

Facilitymedian $1,698 · 10th to 90th $115 to $5,248Professionalmedian $145 · 10th to 90th $102 to $234
$50$200$1K$5Kfacility $1,698professional $145

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
$114.82
Median
$1,698.24
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$141.25
Typical High
$234.42
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$4,073.80
Typical High
$5,888.44
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$162.18
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$162.18
Typical High
$257.04
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$0.72
Median
$134.90
Typical High
$199.53
Hometown Health
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$223.87
Select Health
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$134.90
Typical High
$147.91
Select Health
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$93.33
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$776.25
Typical High
$3,162.28
United
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$144.54
Typical High
$239.88

Where Nevada 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.

Nevada· 34th of 51

$148

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.