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Needle Biopsy of a Salivary Gland

Georgia rates for HCPCS 42400

In this procedure, a doctor uses a thin needle to take a small tissue sample from a salivary gland, usually to evaluate a lump or swelling in the gland. The sample is then examined under a microscope to help determine whether the growth is benign or something that needs further treatment.

Rates data updated October 2026.

How much does Needle Biopsy of a Salivary Gland cost?

$659

Typical total for the visit. In Georgia, October 2026.

Insurers have agreed to pay about $659 for this procedure. That total is two separate charges: $110 to the doctor who performs it, and $550 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$110$72.44 to $166
Facility feeThe hospital or surgery center$550$363 to $1,413

How much rates vary

Facilitymedian $550 · 10th to 90th $87 to $3,548Professionalmedian $110 · 10th to 90th $56 to $214
$50$100$200$500$1K$2K$5Kfacility $550professional $110

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$54.95
Median
$3,548.13
Typical High
$7,585.78
Aetna
Setting
Professional
Modifier
None
Typical Low
$52.48
Median
$102.33
Typical High
$269.15
Ambetter
Setting
Professional
Modifier
None
Typical Low
$45.71
Median
$81.28
Typical High
$95.50
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$380.19
Median
$776.25
Typical High
$3,630.78
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$109.65
Typical High
$208.93
CareSource
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$47.86
Typical High
$47.86
Cigna
Setting
Facility
Modifier
None
Typical Low
$67.61
Median
$89.13
Typical High
$602.56
Cigna
Setting
Professional
Modifier
None
Typical Low
$58.88
Median
$114.82
Typical High
$199.53
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$56.23
Median
$109.65
Typical High
$158.49
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
United
Setting
Facility
Modifier
None
Typical Low
$331.13
Median
$501.19
Typical High
$2,454.71
United
Setting
Professional
Modifier
None
Typical Low
$54.95
Median
$109.65
Typical High
$229.09
5 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$26.30
Median
$50.12
Typical High
$57.54
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$10.47
Median
$19.95
Typical High
$22.91
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$38.90
Median
$75.86
Typical High
$85.11
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$7.76
Median
$15.14
Typical High
$16.98
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$5.25
Median
$10.00
Typical High
$11.48

Where Georgia sits

The same service costs 13.8 times more in Connecticut than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

Georgia· 29th of 51

$659

$110 physician + $550 facility

CT $2,817MT $205

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.