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Biopsy Of The Roof Of The Mouth

South Carolina 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 $219 · 10th–90th $129$7,9430%10%10th90th$219Professionalmedian $145 · 10th–90th $105$2630%10%10th90th$145$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
$128.82
Median
$5,623.41
Typical High
$21,877.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$144.54
Typical High
$269.15
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$2,238.72
Typical High
$3,388.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$141.25
Typical High
$199.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$120.23
Typical High
$426.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$169.82
Typical High
$346.74
Medcost
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$208.93
Typical High
$213.80
Medcost
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$169.82
Typical High
$281.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$5,888.44
Typical High
$9,772.37
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$144.54
Typical High
$251.19