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Biopsy Of The Roof Of The Mouth

West Virginia 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 $3,631 · 10th–90th $105$3,6310%50%10th$3,631Professionalmedian $138 · 10th–90th $100$2290%10%20%10th90th$138$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$104.71
Median
$3,630.78
Typical High
$3,630.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$134.90
Typical High
$229.09
CareSource
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$138.04
CareSource
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$173.78
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$165.96
Typical High
$870.96
United
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$758.58
Typical High
$4,365.16
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$134.90
Typical High
$223.87