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Biopsy Of The Roof Of The Mouth

Washington 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 $288 · 10th–90th $145$5,8880%10%10th90th$288Professionalmedian $174 · 10th–90th $107$3800%10%10th90th$174$10.0$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
$213.80
Median
$407.38
Typical High
$13,489.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$158.49
Typical High
$416.87
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$4,677.35
Typical High
$8,317.64
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$234.42
Typical High
$338.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$467.74
Typical High
$630.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$213.80
Typical High
$416.87
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$234.42
Typical High
$501.19
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$213.80
Typical High
$354.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$72.44
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$281.84
Typical High
$295.12
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$199.53
Typical High
$199.53
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$218.78
Typical High
$371.54
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$2,884.03
Median
$4,466.84
Typical High
$8,317.64
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$234.42
Typical High
$338.84
United
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$4,466.84
Typical High
$8,709.64
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$186.21
Typical High
$346.74
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$154.88
Typical High
$218.78