go back

Biopsy Of The Roof Of The Mouth

Tennessee 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 $2,042 · 10th–90th $372$3,9810%10%10th90th$2,042Professionalmedian $148 · 10th–90th $107$2690%10%10th90th$148$50.0$200.0$1.0K$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
$316.23
Median
$1,778.28
Typical High
$4,073.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$147.91
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$141.25
BCBS
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$2,137.96
Typical High
$2,951.21
BCBS
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$190.55
Typical High
$309.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$199.53
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$162.18
Typical High
$275.42
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$3,890.45
Typical High
$3,890.45
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,230.27
Typical High
$1,230.27
United
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$2,089.30
Typical High
$3,715.35
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$151.36
Typical High
$263.03