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/>
San Angelo, TX
See all hospitals reporting CPT 17004 →Price type
Shannon River Crest Hospital’s median price of $506 is 12% above the median hospital's median price ($452), higher than 56% 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: 4 payers, 6 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 | Molina managed medicaid facility · fee schedule · outpatient | $102 | $102 | — | — | — | $102 – $102 |
| 2 | Bcbs Tx hmo facility · fee schedule · outpatient | $292 | $292 | — | — | — | $292 – $292 |
| 3 | Bcbs Tx bav facility · fee schedule · outpatient | $308 | $308 | — | — | — | $308 – $308 |
| 4 | Bcbs Tx ppo facility · fee schedule · outpatient | $308 | $308 | — | — | — | $308 – $308 |
| 5 | Humana medicare advantage facility · case rate · outpatient | $375 | $375 | — | — | — | $375 – $375 |
| 6 | Ambetter ppo facility · case rate · outpatient | $807 | $807 | — | — | — | $807 – $807 |
Last updated: Dec 8, 2025
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