Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
DESTROY PREMAL LESIONS 15/>
Smithville, TX
See all hospitals reporting CPT 17004 →Price type
Ascension Seton’s median price of $97 is 79% below the median hospital's median price ($453), higher than 2% of the 1,841 hospitals reporting CPT 17004. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 22 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient | $78 | $78 | — | — | — | $78 – $78 |
| 2 | Blue Cross Blue Shield 4168_blue cross chip (chi,dcn) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 3 | Blue Cross Blue Shield 4168_blue cross chip/star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 4 | Blue Cross Blue Shield 4174_blue cross chip (smv) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 5 | Blue Cross Blue Shield 4174_blue cross chip/star kids (smv) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 6 | Blue Cross Blue Shield 4219_chirp blue cross star (chi,dcn) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 7 | Blue Cross Blue Shield 4225_chirp blue cross star (smv) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 8 | Blue Cross Blue Shield 5003_blue cross star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 9 | Blue Cross Blue Shield 5015_blue cross star kids (smv) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 10 | UnitedHealthcare 4253_chirp uhc star (chi,dcn) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 11 | UnitedHealthcare 4259_chirp uhc star (smv) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 12 | UnitedHealthcare 4264_chirp uhc star plus (chi,dcn) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 13 | UnitedHealthcare 4270_chirp uhc star plus (smv) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 14 | UnitedHealthcare 4311_uhc star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 15 | UnitedHealthcare 4317_uhc star kids (smv) outpatient 20241201 fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 16 | Blue Cross Blue Shield 4440_blue cross blue shield hpn 20250501 fee schedule · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 17 | Blue Cross Blue Shield 4497_blue cross blue shield hpn (dell, williamson,hays) 20250501 fee schedule · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 18 | Blue Cross Blue Shield 4095_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $111 | $111 | — | — | — | $111 – $111 |
| 19 | Blue Cross Blue Shield 4094_blue cross blue shield ppo 20250101 fee schedule · outpatient | $126 | $126 | — | — | — | $126 – $126 |
| 20 | Tricare 1229_tricare cah outpatient 20170101 fee schedule · outpatient | $218 | $218 | — | — | — | $218 – $218 |
| 21 | Humana 206_humana hmo custom 20140201 other · outpatient | $969 | $969 | — | — | — | $969 – $969 |
| 22 | Oscar 4511_oscar health plan 20251001 other · both | $1k | $1k | — | — | — | $1k – $1k |
Last updated: Jan 1, 2026
See Removal of 15 or more precancerous skin lesions pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.