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Salivary Gland Biopsy

North Carolina rates for HCPCS 42405

This procedure removes a small sample of tissue from a salivary gland through a surgical cut, so it can be examined under a microscope. It is used to help diagnose a lump, swelling, or other abnormality found in a salivary gland.

Rates data updated July 2026.

How much does Salivary Gland Biopsy cost?

$380

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $380 for this service. The price depends on where it is billed: about $380 from a physician practice, and about $372 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$380$288 to $562
FacilityA hospital or hospital-owned outpatient department$372$288 to $646

How much rates vary

Facilitymedian $372 · 10th to 90th $224 to $4,365Professionalmedian $380 · 10th to 90th $240 to $776
$200$500$1K$2K$5Kfacility $372professional $380

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$1,659.59
Typical High
$7,244.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$295.12
Typical High
$645.65
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$524.81
Typical High
$562.34
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,548.82
Median
$1,819.70
Typical High
$2,041.74
BCBS
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$446.68
Typical High
$870.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$758.58
Typical High
$1,122.02
Cigna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$380.19
Typical High
$660.69
Medcost
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Medcost
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$323.59
Typical High
$524.81
Medcost
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$776.25
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$302.00
United
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$2,041.74
Typical High
$6,309.57
United
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$288.40
Typical High
$512.86
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$28,840.32
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$2,187.76
Median
$2,187.76
Typical High
$2,570.40

Where North Carolina sits

The same service costs 2.1 times more in Minnesota than in Kentucky. 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.

North Carolina· 7th of 51

$380

MN $589KY $275

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.