17042104 — 17042104 Excision Lesion Mouth Roof Ed Charge
Cite this view
HANK Price Transparency. (n.d.). 17042104 EXCISION LESION MOUTH ROOF ED Charge (OTHER 17042104) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/17042104?code_type=OTHER
“17042104 EXCISION LESION MOUTH ROOF ED Charge (OTHER 17042104) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/17042104?code_type=OTHER. Accessed .
“17042104 EXCISION LESION MOUTH ROOF ED Charge (OTHER 17042104) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/17042104?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,654–$3,654 (25th–75th percentile) across 1 hospital · 10 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 17042104 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| MIDWEST MEDICAL CENTER Outpatient | Humana | Medicare Advantage | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Outpatient | Humana | Commercial Services | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Uhc | Commercial | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Medical Associates | Hmo | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Medical Associates | Preffered Health Choices Llc | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Medical Associates | Mahp | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Medical Associates | Health Plan Of Wisconsin Mahp | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Medical Associates | Health Plan Of Wisconsin Hmo | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Aetna Illinois | Government Programs | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Aetna Illinois | Non-Gated Health | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Aetna Illinois | Gated Health | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Aetna Illinois | Workers' Compensation | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Blue Cross Blue Shield Of Illinois | Ppo | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Blue Cross Blue Shield Of Illinois | Blue Choice | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Dean Health | Badgercare Plus | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Hfn Inc. | Group Health Epo-Ppo | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Outpatient | Hfn Inc. | Workers' Compensation Ppo | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Quartz Health Solutions Inc | Fully Insured | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Quartz Health Solutions Inc | Self Insured | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Outpatient | Quartz Health Solutions Inc | Senior Preferred | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Inpatient | Employer Health Care | Alliance Cooperative | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Outpatient | Health Alliance Medical Plans Inc | Fully Insured | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |
| MIDWEST MEDICAL CENTER Outpatient | Health Alliance Medical Plans Inc | Medicare Plans | — | $4,810.80 | $4,377.83 | 2026-05-06 | MRF ↗ |