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
Destruction Premalignant Lesion 15/> Pf
Perryville, MO
See all hospitals reporting CPT 17004 →Price type
Mercy Perry’s median price of $334 is 26% below the median hospital's median price ($452), higher than 23% of the 1,860 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: 16 payers, 34 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 | Medicaid hb wash jefn linc samc pcmh stod il medicaid facility · percent of total billed charges · outpatientfrom % of charges | $68 | $68 | $8 | 12% | — | $60 – $77 |
| 2 | Blue Cross Blue Shield hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $138 | $138 | $17 | 12% | — | $121 – $155 |
| 3 | Humana hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $138 | $138 | $17 | 12% | — | $121 – $155 |
| 4 | Medica hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $138 | $138 | $17 | 12% | — | $121 – $155 |
| 5 | Medicare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $138 | $138 | $17 | 12% | — | $121 – $155 |
| 6 | UnitedHealthcare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $138 | $138 | $17 | 12% | — | $121 – $155 |
| 7 | WellCare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $138 | $138 | $17 | 12% | — | $121 – $155 |
| 8 | UnitedHealthcare hb pcmh uhc medicare w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $141 | $141 | $17 | 12% | — | $123 – $158 |
| 9 | Aetna hb pcmh aetna/coventry medicare 102% w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $144 | $144 | $18 | 12% | — | $126 – $161 |
| 10 | Devoted hb pcmh devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $144 | $144 | $18 | 12% | — | $126 – $161 |
| 11 | Tricare hb pcmh tricare facility · percent of total billed charges · outpatientfrom % of charges | $165 | $165 | $20 | 12% | — | $144 – $185 |
| 12 | Medica hb linc pcmh medica exchange new 010122 facility · percent of total billed charges · outpatientfrom % of charges | $191 | $191 | $24 | 12% | — | $167 – $214 |
| 13 | Ambetter hb pcmh ambetter exchange facility · percent of total billed charges · outpatientfrom % of charges | $215 | $215 | $27 | 12% | — | $189 – $242 |
| 14 | Blue Cross Blue Shield hb stlo wash jefn linc samc cape stod pcmh bcbs ascension facility · percent of total billed charges · outpatientfrom % of charges | $216 | $216 | $27 | 12% | — | $189 – $242 |
| 15 | UnitedHealthcare hb pcmh uhc core facility · percent of total billed charges · outpatientfrom % of charges | $259 | $259 | $32 | 12% | — | $227 – $291 |
| 16 | Aetna hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $297 | $297 | $37 | 12% | — | $261 – $334 |
| 17 | First Health hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $297 | $297 | $37 | 12% | — | $261 – $334 |
| 18 | Optum hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $300 | $300 | $37 | 12% | — | $263 – $337 |
| 19 | UnitedHealthcare hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $300 | $300 | $37 | 12% | — | $263 – $337 |
| 20 | Blue Cross Blue Shield hb pcmh anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges | $316 | $316 | — | — | — | $316 – $316 |
| 21 | Blue Cross Blue Shield hb pcmh anthem pathway/exchange facility · percent of total billed charges · outpatientfrom % of charges | $316 | $316 | — | — | — | $316 – $316 |
| 22 | Cigna hb pcmh cigna facility · percent of total billed charges · outpatientfrom % of charges | $338 | $338 | $42 | 12% | — | $297 – $380 |
| 23 | Medicaid hb pcmh mo medicaid facility · fee schedule · outpatient | $341 | $341 | — | — | — | $341 – $341 |
| 24 | UnitedHealthcare hb pcmh uhc managed medicaid facility · fee schedule · outpatient | $341 | $341 | — | — | — | $341 – $341 |
| 25 | Anthem hb pcmh anthem blue access facility · percent of total billed charges · outpatientfrom % of charges | $357 | $357 | — | — | — | $357 – $357 |
Last updated: Mar 12, 2026
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