12004 (CPT) by state — Price Transparency

CPT · across United States

12004 — Rpr S/n/ax/gen/trk7.6-12.5cm

State-by-state median negotiated rates. Lower bars are cheaper states; the range bar shows the IQR (25th to 75th percentile within each state).

$320 National median

$197 – $586 IQR (p25 – p75)

3,626 hospitals filing

55 states

View hospital-by-hospital → Raw rate rows →

Estimate your cost

What would you pay?

Plug in your deductible, what you've already spent against it, your OOP-max, and your coinsurance %. We'll math the rest. Math reference: methodology.

This estimate runs on the hospital’s facility charge only. The surgeon’s and anesthesiologist’s fees are billed separately and aren’t in this number — your EOB shows your complete total.

Uninsured estimates use the cash / self-pay median for this code: $394.

I am… Annual deductible (assumed — typical plan) Already spent this year

Checked your insurer’s portal? Enter your remaining deductible and out-of-pocket max above/below and leave “already spent” at 0.

Out-of-pocket max (assumed — typical plan) Coinsurance % (after deductible)

Loading estimate…

Median negotiated rate, by state

Ranked by typical (median) negotiated price. Hover for state-level IQR.

Median negotiated rate by state for 12004 (CPT), with interquartile range
State	Median	p25	p75
PR	$131	$123	$147
MI	$195	$94	$310
AS	$197	$89	$411
WV	$201	$157	$353
NM	$205	$136	$579
VT	$209	$160	$368
AL	$210	$177	$361
AZ	$214	$174	$390
NH	$214	$123	$477
AR	$221	$180	$461
MS	$228	$158	$364
SC	$228	$190	$520
IA	$233	$153	$373
TN	$233	$182	$564
KY	$237	$167	$406
PA	$241	$188	$599
LA	$250	$172	$414
OH	$255	$191	$365
OR	$264	$219	$563
NE	$266	$184	$425
TX	$277	$199	$542
RI	$280	$206	$659
DC	$282	$214	$400
ID	$282	$179	$427
UT	$283	$128	$407
IN	$284	$167	$497
MO	$287	$192	$511
KS	$292	$191	$543
CA	$292	$247	$758
NC	$293	$221	$500
ME	$306	$196	$513
CT	$311	$191	$469
VI	$312	$276	$332
ND	$323	$226	$419
OK	$324	$189	$453
WA	$329	$223	$658
MA	$343	$237	$535
MD	$359	$254	$555
IL	$361	$217	$595
NV	$361	$218	$681
NY	$371	$197	$770
MT	$383	$169	$563
WY	$386	$199	$652
CO	$399	$200	$634
GA	$412	$198	$1,178
FL	$428	$212	$1,271
SD	$436	$218	$578
MN	$444	$316	$630
GU	$456	$456	$456
HI	$514	$253	$712
VA	$530	$208	$910
WI	$545	$461	$1,049
DE	$612	$224	$654
NJ	$650	$290	$1,063
AK	$664	$318	$949

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
State	Median	p25	p75	Min	Max	Hospitals	Payers	Rates

PR	$131	$123	$147	$99	$162	4	10	17
MI	$195	$94	$310	<$1	$2,546	89	559	5,310
AS	$197	$89	$411	$89	$411	1 ⚠ thin data	1	9
WV	$201	$157	$353	$25	$1,787	33	137	1,620
NM	$205	$136	$579	$62	$14,041	29	165	840
VT	$209	$160	$368	$46	$1,107	12	53	626
AL	$210	$177	$361	$1	$25,048	59	285	1,704
AZ	$214	$174	$390	$63	$15,287	49	478	2,573
NH	$214	$123	$477	$30	$8,965	19	101	1,042
AR	$221	$180	$461	$10	$19,758	61	420	2,860
MS	$228	$158	$364	<$1	$14,227	65	594	4,119
SC	$228	$190	$520	<$1	$14,554	51	191	2,325
IA	$233	$153	$373	<$1	$3,702	99	311	4,310
TN	$233	$182	$564	<$1	$30,440	91	292	4,975
KY	$237	$167	$406	$22	$10,784	69	170	2,942
PA	$241	$188	$599	$1	$12,413	123	351	6,950
LA	$250	$172	$414	$2	$17,881	79	583	5,031
OH	$255	$191	$365	<$1	$12,878	100	528	5,338
OR	$264	$219	$563	$3	$7,246	49	477	3,899
NE	$266	$184	$425	$3	$7,437	74	183	2,699
TX	$277	$199	$542	<$1	$22,109	353	1,037	16,085
RI	$280	$206	$659	$63	$5,101	9	52	293
DC	$282	$214	$400	$133	$2,878	4	18	72
ID	$282	$179	$427	$51	$2,120	36	268	1,850
UT	$283	$128	$407	$4	$4,460	42	188	3,170
IN	$284	$167	$497	$12	$14,356	70	410	4,293
MO	$287	$192	$511	$26	$30,000	71	364	5,674
KS	$292	$191	$543	$2	$77,875	108	465	3,761
CA	$292	$247	$758	<$1	$50,000	259	1,504	14,775
NC	$293	$221	$500	$48	$10,074	71	201	3,768
ME	$306	$196	$513	$40	$2,268	31	36	922
CT	$311	$191	$469	$25	$6,273	24	61	630
VI	$312	$276	$332	$246	$395	1 ⚠ thin data	6	12
ND	$323	$226	$419	$41	$2,000	29	76	887
OK	$324	$189	$453	<$1	$12,396	93	322	3,631
WA	$329	$223	$658	$24	$13,212	80	289	4,865
MA	$343	$237	$535	$1	$50,000	48	361	2,842
MD	$359	$254	$555	$124	$1,795	3	20	85
IL	$361	$217	$595	$3	$10,175	133	606	8,354
NV	$361	$218	$681	$12	$7,328	31	302	1,451
NY	$371	$197	$770	$3	$76,965	139	572	12,320
MT	$383	$169	$563	$41	$13,091	45	327	2,470
WY	$386	$199	$652	$10	$1,066	22	103	637
CO	$399	$200	$634	$8	$6,419	79	314	3,921
GA	$412	$198	$1,178	$27	$37,500	110	210	3,235
FL	$428	$212	$1,271	<$1	$122,320	170	906	10,564
SD	$436	$218	$578	$3	$5,410	45	138	1,891
MN	$444	$316	$630	$20	$50,000	100	388	11,275
GU	$456	$456	$456	$456	$456	1 ⚠ thin data	4	4
HI	$514	$253	$712	$71	$2,783	19	35	643
VA	$530	$208	$910	$66	$11,338	51	96	2,096
WI	$545	$461	$1,049	$1	$16,897	110	553	10,229
DE	$612	$224	$654	$119	$1,047	4	19	52
NJ	$650	$290	$1,063	$12	$12,000	60	294	4,285
AK	$664	$318	$949	$72	$6,642	12	33	181