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Biopsy Of The Roof Of The Mouth

Texas 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 $257 · 10th–90th $110$3,9810%5%10th90th$257Professionalmedian $148 · 10th–90th $105$2240%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
$436.52
Median
$2,187.76
Typical High
$6,918.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$147.91
Typical High
$218.78
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$144.54
Typical High
$144.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$151.36
Typical High
$660.69
BCBS
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$131.83
Typical High
$190.55
Christus
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$43.65
Typical High
$144.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$141.25
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$169.82
Typical High
$323.59
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$56.23
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
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$165.96
Typical High
$295.12
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$186.21
Typical High
$281.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$123.03
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$162.18
Providence
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$165.96
Typical High
$295.12
Providence
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$177.83
Typical High
$338.84
United
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$2,041.74
Typical High
$4,073.80
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$141.25
Typical High
$223.87
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$144.54
Typical High
$199.53