Excision lesion mouth roof (CPT 42104)

42104 is the billing code hospitals use for this service. Prices below are each hospital's own posted facility charge.

Name shown as it appears in hospital billing files.

207 of 2110 hospitals post a price for this code. Hospitals that don't post one are left out. We never guess a number.

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HospitalLocationCash priceGross chargeMedicare pays× Medicare
Washington County Hospital and Nursing Home Chatom, AL $54.17 $2,857.43 0.0×
Unity Health - White County Medical Center Searcy, AR $68.25 $273 $3,018.80 0.0×
Unity Health - Jacksonville Jacksonville, AR $68.25 $273 $3,115.14 0.0×
Unity Health - Newport Newport, AR $68.25 $273 $3,018.80 0.0×
Memorial Health Lawton, OK $99.74 $79.79 $3,188.71 0.0×
Ozarks Healthcare West Plains, MO $103.50 $207 $3,320.81 0.0×
Pawnee Valley Community Hospital Larned, KS $120 $300 $3,049.08 0.0×
Nacogdoches Memorial Hospital Nacogdoches, TX $127 $424 $3,330.57 0.0×
North Texas Medical Center Gainesville, TX $132 $529 $3,330.57 0.0×
Memorial Medical Center Port Lavaca, TX $147.26 $210.37 $3,330.57 0.0×
East Carroll Parish Hospital Lake Providence, LA $162.75 $217 $3,018.60 0.1×
Breckinridge Memorial Hospital Hardinsburg, KY $169.50 $339 $3,110.87 0.1×
Nemaha County Hospital Auburn, NE $193 $193 $3,442.75 0.1×
Ste. Genevieve County Memorial Hospital Ste. Genevieve, MO $198.50 $397 $3,320.81 0.1×
T.J. Samson Community Hospital Glasgow, KY $200.85 $309 $3,147.45 0.1×
Pike County Memorial Hospital Louisiana, MO $219.20 $274 $3,320.81 0.1×
Conway Medical Center Conway, SC $227 $227 $3,083.64 0.1×
White River Medical Center Batesville, AR $251.25 $335 $3,018.80 0.1×
Kingman Regional Medical Center Kingman, AZ $252 $720 $3,537.87 0.1×
Community Memorial Healthcare, Inc Marysville, KS $260.70 $260.70 $3,049.08 0.1×
Fitzgibbon Hospital Marshall, MO $286.71 $358.39 $3,320.81 0.1×
Carroll County Memorial Hospital Carrollton, MO $292.50 $4,425 $3,320.81 0.1×
Sublette County Health Pinedale, WY $294.30 $327 $3,387.27 0.1×
UAB Medical West Bessemer, AL $302.25 $403 $3,032.62 0.1×
Spanish Peaks Regional Health Center Walsenburg, CO $330.30 $367 $3,497.42 0.1×
Jefferson Regional Pine Bluff, AR $332 $332 $3,085.06 0.1×
Pratt Regional Medical Center Pratt, KS $345 $493 $3,049.08 0.1×
DeSoto Regional Health System Mansfield, LA $350 $500 $3,002.14 0.1×
CarolinaEast Medical Center New Bern, NC $357 $595 $3,168.99 0.1×
Sheridan Memorial Hospital Sheridan, WY $412 $515 $3,387.27 0.1×
Citizens Memorial Hospital Bolivar, MO $421.60 $527 $3,320.81 0.1×
Mizell Memorial Hospital Opp, AL $425.70 $473 $2,857.43 0.1×
UNC Health Chatham Siler City, NC $431.40 $719 $3,299.07 0.1×
Titus Regional Medical Center Mount Pleasant, TX $442.80 $738 $3,330.57 0.1×
Baptist Hospital Pensacola, FL $443.70 $2,958 $3,462.26 0.1×
North Central Kansas Medical Center Concordia, KS $450.24 $643.20 $3,049.08 0.1×
University Health Truman Medical Center Kansas City, MO $479.60 $872 $3,320.81 0.1×
University Health Lakewood Medical Center Kansas City, MO $479.60 $872 $3,320.81 0.1×
Hays Medical Center Hays, KS $490.05 $1,485 $3,323.05 0.1×
Genoa Community Hospital Genoa, NE $540 $600 $3,442.75 0.2×
OU Health University of Oklahoma Medical Center Oklahoma City, OK $541.02 $5,410.26 $3,188.71 0.2×
St. John's Medical Center Jackson, WY $576 $576 $3,387.27 0.2×
Baylor Scott and White Medical Center Uptown Dallas, TX $628.20 $1,047 $3,330.57 0.2×
Memorial Hospital Abilene, KS $643.20 $643.20 $3,049.08 0.2×
North Central Surgical Center Llp Dallas, TX $704.40 $1,174 $3,330.57‡ 0.2×
Colquitt Regional Medical Center Moultrie, GA $772 $772 $3,002.54 0.3×
Memorial Hermann Surgical Hospital Kingwood Kingwood, TX $780.85 $2,231 $3,330.57 0.2×
Tops Surgical Specialty Hospital Houston, TX $809.20 $2,312 $3,330.57 0.2×
Animas Surgical Hospital Durango, CO $811 $811 $3,497.42 0.2×
Parkland Memorial Hospital Dallas, TX $849.56 $2,123.90 $3,330.57 0.3×
Nebraska Medical Center Omaha, NE $889.66 $1,368.70 $3,442.75 0.3×
Bellevue Medical Center Bellevue, NE $889.66 $1,368.70 $3,442.75 0.3×
Baylor Scott and White Surgical Hospital Las Colin Irving, TX $919.80 $1,533 $3,330.57 0.3×
Aspen Valley Hospital Aspen, CO $920 $920 $3,497.42 0.3×
University of Kansas Hospital Kansas City, KS $958 $4,790 $3,095.42 0.3×
The University of Kansas Health System Paola Hospital Paola, KS $958 $4,790 $3,166.96 0.3×
Hedrick Medical Center Chillicothe, MO $1,089.60 $1,816 $3,320.81 0.3×
University of Kansas Health System Olathe Hospital Olathe, KS $1,131.02 $5,655.10 $3,138.92 0.4×
Baylor Scott and White Surgical Hospital at Sherma Sherman, TX $1,156.80 $1,928 $3,341.75 0.3×
Baylor Scott & White Texas Spine & Joint Hospital Tyler, TX $1,252.20 $2,087 $3,330.57 0.4×
Ochsner Medical Center - New Orleans New Orleans, LA $1,266.98 $5,759 $3,112.09 0.4×
Vanderbilt Bedford Hospital Shelbyville, TN $1,308.48 $4,512 $3,165.95 0.4×
Vanderbilt Tullahoma-Harton Hospital Tullahoma, TN $1,308.48 $4,512 $3,147.45 0.4×
Vanderbilt Wilson County Hospital Lebanon, TN $1,308.48 $4,512 $3,180.78 0.4×
East Jefferson General Hospital Metairie, LA $1,349.60 $9,640 $3,112.09 0.4×
Baylor Scott and White Surgical Hospital Fortworth Fort Worth, TX $1,450.80 $2,418 $3,336.05 0.4×
Anderson County Hospital Garnett, KS $1,536 $2,560 $3,049.08 0.5×
Beaufort Memorial Beaufort, SC $1,539 $2,565 $3,083.64 0.5×
West Jefferson Medical Center Marrero, LA $1,542.40 $9,640 $3,112.09 0.5×
Sugar Land Surgical Hospital Llp Sugar Land, TX $1,611 $2,685 $3,330.57 0.5×
Baptist Health Medical Center-North Little Rock North Little Rock, AR $1,732.64 $6,930.56 $3,115.14 0.6×
Permian Regional Medical Center Andrews County Ho Andrews, TX $1,743.50 $3,487 $3,330.57 0.5×
Ochsner Medical Center - Baton Rouge Baton Rouge, LA $1,751.04 $5,472 $3,002.14 0.6×
Ochsner Acadia General Hospital Crowley, LA $1,789.34 $7,779.72 $3,002.14 0.6×
Freeman Neosho Hospital Neosho, MO $1,815.90 $3,026.50 $3,320.81 0.5×
CaroMont Regional Medical Center Gastonia, NC $1,876 $1,876 $3,221.84 0.6×
Baptist Health Medical Center-Conway Conway, AR $1,953.98 $7,815.91 $3,115.14 0.6×
Baptist Health Medical Center-Magnolia Magnolia, AR $1,953.98 $7,815.91 $3,018.80 0.6×
Golden Valley Memorial Healthcare Clinton, MO $1,979.15 $3,298.59 $3,320.81 0.6×
Baylor Scott & White Medical Center -taylor Taylor, TX $1,982.80 $3,304.66 $3,330.57 0.6×
Scott & White Hospital-round Rock Round Rock, TX $1,982.80 $3,304.66 $3,330.57 0.6×
Baylor Scott & White Medical Center - Pflugerville Pflugerville, TX $1,982.80 $3,304.66 $3,330.57 0.6×
Baylor Scott & White Medical Center - Buda Buda, TX $1,982.80 $3,304.66 $3,330.57 0.6×
Baylor Scott & White Medical Center- Austin Austin, TX $1,982.80 $3,304.66 $3,330.57 0.6×
Methodist Fremont Health Fremont, NE $2,026.12 $5,476 $3,442.75 0.6×
UCHealth University of Colorado Hospital Aurora, CO $2,245.25 $6,415 $3,497.42 0.6×
Iron County Medical Center Pilot Knob, MO $2,277 $2,530 $3,320.81 0.7×
Baylor Scott & White Medical Center - Temple Temple, TX $2,290.13 $3,816.89 $3,330.57 0.7×
Baylor Scott & White Medical Center - Hillcrest Waco, TX $2,290.13 $3,816.89 $3,330.57 0.7×
Baylor Scott & White Medical Center- College Stati College Station, TX $2,290.13 $3,816.89 $3,330.57 0.7×
Baylor Scott & White Medical Center - Marble Falls Marble Falls, TX $2,290.13 $3,816.89 $3,330.57 0.7×
Baylor Scott & White Hospital Brenham Brenham, TX $2,290.13 $3,816.89 $3,330.57 0.7×
Phelps Health Hospital Rolla, MO $2,375.86 $3,394.08 $3,320.81 0.7×
Denver Health Medical Center Denver, CO $2,436.39 $6,961.10 $3,497.42 0.7×
Vanderbilt University Hospital Nashville, TN $2,436.48 $4,512 $3,254.56 0.7×
Jackson Hospital Montgomery, AL $2,513.01 $13,226.38 $2,973.68 0.8×
University Medical Center New Orleans New Orleans, LA $2,608.54 $11,857 $3,002.14 0.9×
UAMS Medical Center Little Rock, AR $2,657.40 $4,429 $3,115.14 0.9×
Pecos County Memorial Hospital Fort Stockton, TX $2,659 $3,545 $3,330.57 0.8×
Great Plains Health North Platte, NE $2,728 $4,774 $3,442.75 0.8×
Pikeville Medical Center Pikeville, KY $2,754.90 $9,183 $3,110.87 0.9×
Mercy Hospital Fort Smith Fort Smith, AR $2,851.77 $4,387.34 $3,211.27 0.9×
Lafayette Surgical Specialty Hospital Lafayette, LA $2,897 $2,897 $3,002.14 1.0×
Harris Health Houston, TX $2,937 $2,937 $3,330.57 0.9×
Park Place Surgical Hospital Lafayette, LA $2,944.22 $7,317.19 $3,002.14 1.0×
Troy Regional Troy, AL $3,000 $9,000 $2,918.40 1.0×
Northwest Hills Surgical Hospital Austin, TX $3,110.40 $8,640 $3,330.57 0.9×
Onvida Health Yuma Medical Center Yuma, AZ $3,110.90 $4,786 $3,537.87 0.9×
Trigg County Hospital Cadiz, KY $3,144.80 $357 $3,254.56 1.0×
University Hospital Columbia, MO $3,165.60 $5,276 $3,320.81 1.0×
East Alabama Medical Center Opelika, AL $3,168.55 $5,761 $2,882.43 1.1×
Parkview Medical Center Pueblo, CO $3,243.08 $8,107.68 $3,497.42 0.9×
Lakeside Medical Center Belle Glade, FL $3,255.33 $3,462.26 0.9×
Ochsner LSU Health - St. Mary Medical Center Shreveport, LA $3,289.07 $11,746.67 $3,002.14 1.1×
Sentara Albemarle Medical Center Elizabeth City, NC $3,367.50 $6,735 $3,168.99 1.1×
Laredo Medical Center Laredo, TX $3,500.30 $14,584.60 $3,330.57 1.1×
Our Lady of the Lake Surgical Hospital Slidell, LA $3,561.05 $3,010.88 1.2×
Memorial Hermann Houston Physicians Hospital Webster, TX $3,573.15 $5,537 $3,330.57 1.1×
Mercy Hospital Oklahoma City, Inc Oklahoma City, OK $3,578.41 $5,505.24 $3,188.71 1.1×
Midwest Surgical Hospital LLC Omaha, NE $3,599.25 $4,799 $3,442.75 1.0×
Mercy Hospital St. Louis St. Louis, MO $3,608.41 $5,551.40 $3,320.81 1.1×
Hilton Head Medical Center Hilton Head Island, SC $3,669.88 $3,083.64 1.2×
East Cooper Medical Center Mount Pleasant, SC $3,669.88 $3,083.64 1.2×
Coastal Carolina Medical Center Hardeeville, SC $3,669.88 $3,083.64 1.2×
Summit Medical Center, LLC Edmond, OK $3,726.86 $3,188.71 1.2×
Atrium Health Cabarrus Concord, NC $3,728.50 $7,457 $3,221.84 1.2×
Atrium Health Cleveland Shelby, NC $3,728.50 $7,457 $3,196.43 1.2×
Atrium Health Anson Wadesboro, NC $3,728.50 $7,457 $3,221.84 1.2×
Atrium Health Pineville Charlotte, NC $3,728.50 $7,457 $3,221.84 1.2×
Atrium Health Carolinas Medical Center Charlotte, NC $3,728.50 $7,457 $3,221.84 1.2×
Atrium Health Stanly Albemarle, NC $3,728.50 $7,457 $3,221.84 1.2×
Atrium Health Union Monroe, NC $3,728.50 $7,457 $3,221.84 1.2×
Atrium Health Lincoln Lincolnton, NC $3,728.50 $7,457 $3,221.84 1.2×
Atrium Health University City Charlotte, NC $3,728.50 $7,457 $3,221.84 1.2×
Methodist Hospital Omaha, NE $3,824.64 $10,624 $3,442.75 1.1×
Griffin Hospital Derby, CT $3,877.03 $3,974.62 1.0×
Charlotte Hungerford Hospital Torrington, CT $3,900.21 $3,900.21 $3,974.62 1.0×
Sidney Regional Medical Center Sidney, NE $3,963 $3,963 $3,442.75 1.2×
High Point Medical Center High Point, NC $3,995 $7,990 $3,215.54 1.2×
Atrium Health Wake Forest Baptist Medical Center Winston-Salem, NC $3,995 $7,990 $3,215.54 1.2×
Ozarks Community Hospital Gravette, AR $4,059.60 $5,253 $3,094.41 1.3×
Valleywise Health Medical Center Phoenix, AZ $4,068.55 $5,900 $3,537.87 1.1×
Monroe Regional Hospital Aberdeen, MS $4,128 $4,128 $2,858.45 1.4×
Saint Thomas Hospital for Specialty Surgery Nashville, TN $4,145.32 $3,180.78 1.3×
Legent Orthopedic Hospital Carrollton, TX $4,170.07 $14,270.40 $3,336.05 1.3×
SSM Health St. Anthony Hospital - Oklahoma City Oklahoma City, OK $4,211.35 $7,657 $3,188.71 1.3×
Manhattan Surgical Hospital LLC Manhattan, KS $4,222.50 $8,445 $3,049.08 1.4×
SSM Health Saint Louis University Hospital St. Louis, MO $4,323 $7,860 $3,320.81 1.3×
Tallahassee Memorial Hospital Tallahassee, FL $4,337.59 $6,196.56 $3,462.26 1.3×
MedStar Washington Hospital Center Washington, DC $4,415.27 $6,792.72 $3,916.70 1.1×
Lee Memorial Hospital Fort Myers, FL $4,569.75 $22,848.74 $3,462.26 1.3×
Gulf Coast Medical Center Fort Myers, FL $4,569.75 $22,848.74 $3,462.26 1.3×
Cape Coral Hospital Cape Coral, FL $4,569.75 $22,848.74 $3,462.26 1.3×
Yale New Haven Hospital New Haven, CT $4,749.10 $8,049.32 $3,974.62 1.2×
Regional West Medical Center Scottsbluff, NE $4,864.61 $8,107.68 $3,442.75 1.4×
Legent North Houston Surgical Hospital Tomball, TX $4,995.85 $12,905 $3,330.57 1.5×
Emory University Hospital Atlanta, GA $5,507 $5,507 $3,325.49 1.7×
Emory Decatur Hospital Decatur, GA $5,507 $5,507 $3,325.49 1.7×
Emory University Hospital Midtown Atlanta, GA $5,507 $5,507 $3,367.56 1.6×
Emory Saint Joseph's Hospital Atlanta, GA $5,507 $5,507 $3,367.56 1.6×
Emory Hillandale Hospital Lithonia, GA $5,507 $5,507 $3,325.49 1.7×
Emory Johns Creek Hospital Johns Creek, GA $5,507 $5,507 $3,367.56 1.6×
Grady Memorial Hospital Atlanta, GA $5,537.81 $5,537.81 $3,367.56 1.6×
Orlando Health Orlando Regional Medical Center Orlando, FL $5,570.80 $13,927 $3,462.26 1.6×
Orlando Health - Health Central Hospital Ocoee, FL $5,570.80 $13,927 $3,462.26 1.6×
Orlando Health Bayfront Hospital Saint Petersburg, FL $5,570.80 $13,927 $3,462.26 1.6×
Orlando Health South Lake Hospital Clermont, FL $5,570.80 $13,927 $3,462.26 1.6×
Orlando Health Sebastian River Hospital Sebastian, FL $5,570.80 $13,927 $3,462.26 1.6×
Orlando Health Melbourne Hospital Melbourne, FL $5,570.80 $13,927 $3,462.26 1.6×
Orlando Health St. Cloud Hospital Saint Cloud, FL $5,570.80 $13,927 $3,462.26 1.6×
Ascentist Hospital LLC Leawood, KS $5,650.06 $9,439 $3,138.92 1.8×
North Oaks Medical Center Hammond, LA $5,829.75 $16,156 $3,031.40 1.9×
Mercy Hospital Northwest Arkansas Rogers, AR $6,190.12 $9,523.26 $3,094.41 2.0×
Doctors Hosptal at Renaissance Edinburg, TX $6,310.48 $6,310.48 $3,330.57 1.9×
Mercy Hospital Perry Perryville, MO $6,345.56 $9,762.40 $3,320.81 1.9×
Duncan Regional Hospital, Inc Duncan, OK $6,611.96 $3,188.71 2.1×
Boca Raton Regional Hospital Boca Raton, FL $7,184.78 $11,053.50 $3,462.26 2.1×
Baytown Medical Center Lp Baytown, TX $7,257 $7,257 $3,330.57 2.2×
Havasu Regional Medical Center Lake Havasu City, AZ $8,057.30 $13,428.84 $3,621.80 2.2×
Baptist Hospital of Miami Miami, FL $8,548.80 $13,152 $3,462.26 2.5×
Physicians Regional Medical Center - Pine Ridge Naples, FL $9,070.83 $43,194.44 $3,462.26 2.6×
Northwest Surgical Hospital Oklahoma City, OK $9,566.13 $3,188.71 3.0×
Community Hospital, LLC Oklahoma City, OK $9,566.13 $3,188.71 3.0×
Mercy Hospital Pittsburg, Inc Pittsburg, KS $9,665.57 $14,870.11 $3,087.50 3.1×
Glen Rose Medical Center Glen Rose, TX $9,667 $9,667 $3,330.57 2.9×
Saint Luke's Hospital of Kansas City Kansas City, MO $10,836.60 $18,061 $3,320.81 3.3×
Altus Houston Hospital, Lp Houston, TX $11,002 $11,002 $3,330.57 3.3×
Grandview Medical Center Birmingham, AL $11,900.30 $79,335.30 $3,032.62 3.9×
Cleveland Clinic Martin North Hospital Stuart, FL $12,121.20 $18,648 $3,462.26 3.5×
Cleveland Clinic Indian River Hospital Vero Beach, FL $12,121.20 $18,648 $3,462.26 3.5×
Cleveland Clinic Hospital Weston, FL $12,121.20 $18,648 $3,462.26 3.5×
Mercy Hospital Springfield Springfield, MO $12,357 $19,010.77 $3,320.81 3.7×
Faith Community Hospital Jacksboro, TX $12,915 $18,450 $3,330.57 3.9×
Saint Francis Medical Center Cape Girardeau, MO $13,197 $13,197 $3,320.81 4.0×
Omega Hospital Metairie, LA $13,825.12 $23,700.20 $3,112.09 4.4×
Saint Luke's South Hospital Overland Park, KS $14,004.42 $23,340.70 $3,138.92 4.5×
Merit Health River Oaks Flowood, MS $15,397.62 $85,542.36 $2,993.40 5.1×
Lower Keys Medical Center Key West, FL $16,069.58 $59,516.98 $3,462.26 4.6×
Optim Medical Center-Screven Sylvania, GA $18,431 $18,431 $2,905.40 6.3×
Optim Medical Center-Tattnall Reidsville, GA $18,431 $18,431 $2,905.40 6.3×
Western Missouri Medical Center Warrensburg, MO $375.95 $3,320.81
University of Texas M D Anderson Cancer Center Houston, TX $1,356 $3,330.57
Cameron Regional Medical Center Cameron, MO $1,424.50 $3,320.81
Oklahoma Surgical Hospital, LLC Tulsa, OK $7,760 $3,188.71
Onecore Health Oklahoma City, OK $8,864.52 $3,188.71
North Walton Doctors Hospital Defuniak Springs, FL $32,345.46 $3,462.26
Middlesex Hospital Middletown, CT $999,999,999 $3,974.62

"Medicare pays" is the facility (technical) rate, matching the posted facility charge; the doctor's separate professional fee is excluded throughout. "—" means Medicare has no comparable facility rate.

‡ Price taken from the hospital's inpatient list; no outpatient price posted.