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Salivary Gland Biopsy

Ohio 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?

$295

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $295 for this service. The price depends on where it is billed: about $288 from a physician practice, and about $3,020 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 9 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$288$234 to $347
FacilityA hospital or hospital-owned outpatient department$3,020$955 to $4,786

How much rates vary

Facilitymedian $3,020 · 10th to 90th $372 to $10,233Professionalmedian $288 · 10th to 90th $209 to $468
$200$500$1K$2K$5K$10Kfacility $3,020professional $288

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
$323.59
Median
$3,162.28
Typical High
$10,715.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$295.12
Typical High
$501.19
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$380.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$2,511.89
Typical High
$7,943.28
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$275.42
Typical High
$436.52
CareSource
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$239.88
Typical High
$831.76
CareSource
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$269.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$489.78
Typical High
$1,047.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$338.84
Typical High
$588.84
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$602.56
Typical High
$2,290.87
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$338.84
Typical High
$562.34
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$123.03
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$2,398.83
Typical High
$2,398.83
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$309.03
Typical High
$575.44
United
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$2,137.96
Typical High
$4,897.79
United
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$295.12
Typical High
$501.19

Where Ohio 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.

Ohio· 44th of 51

$295

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.