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Biopsy Of The Roof Of The Mouth

Rhode Island 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 $2,399 · 10th–90th $525$5,0120%10%10th90th$2,399Professionalmedian $151 · 10th–90th $112$2140%10%20%10th90th$151$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$1,513.56
Median
$1,548.82
Typical High
$3,981.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$141.25
Typical High
$190.55
BCBS
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$165.96
Typical High
$281.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$446.68
Cigna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$199.53
Typical High
$363.08
United
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$3,467.37
Typical High
$5,495.41
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$154.88
Typical High
$251.19