12055 (HCPCS) by state — Price Transparency

HCPCS · across United States

12055 — Intmd Rpr Face/mm 12.6-20 Cm

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

$639 National median

$398 – $1,072 IQR (p25 – p75)

2,855 hospitals filing

54 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: $731.

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 12055 (HCPCS), with interquartile range
State	Median	p25	p75
AK	$1,192	$724	$3,037
WY	$1,045	$595	$1,446
HI	$986	$493	$1,600
NH	$929	$415	$1,481
WI	$914	$809	$948
OR	$910	$552	$1,692
CO	$897	$457	$1,381
WA	$891	$489	$1,664
GA	$877	$435	$2,511
NJ	$866	$586	$1,570
MD	$840	$511	$1,133
SD	$839	$527	$1,293
NV	$810	$450	$1,943
FL	$804	$433	$1,974
MN	$789	$606	$789
NY	$765	$473	$1,397
IL	$740	$436	$1,038
VA	$716	$407	$1,688
NE	$696	$397	$1,198
KS	$692	$383	$1,082
ND	$663	$452	$897
MO	$656	$399	$1,106
SC	$646	$393	$1,245
OK	$646	$391	$762
MA	$638	$391	$1,118
CA	$627	$508	$1,467
ID	$599	$406	$933
MT	$546	$529	$855
IA	$543	$351	$870
MS	$537	$334	$685
TN	$536	$379	$1,129
NC	$532	$388	$620
PA	$512	$372	$1,242
VI	$506	$486	$550
DE	$495	$453	$686
CT	$492	$383	$861
TX	$478	$359	$1,019
LA	$476	$244	$908
UT	$470	$365	$654
RI	$468	$418	$822
NM	$454	$400	$706
DC	$448	$424	$558
AR	$440	$363	$899
ME	$431	$379	$924
AL	$430	$351	$922
IN	$430	$288	$706
AZ	$426	$347	$830
OH	$425	$370	$792
VT	$422	$379	$570
AS	$412	$385	$440
WV	$394	$329	$530
KY	$376	$277	$572
MI	$364	$214	$496
PR	$293	$293	$293

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

AK	$1,192	$724	$3,037	$451	$15,448	7	29	92
WY	$1,045	$595	$1,446	$32	$2,613	21	99	386
HI	$986	$493	$1,600	$214	$4,720	15	31	307
NH	$929	$415	$1,481	$87	$7,243	14	45	586
WI	$914	$809	$948	$72	$16,897	91	520	5,660
OR	$910	$552	$1,692	$50	$13,592	37	403	2,660
CO	$897	$457	$1,381	$49	$9,888	69	252	2,915
WA	$891	$489	$1,664	$51	$16,508	67	227	3,097
GA	$877	$435	$2,511	$100	$50,000	77	156	2,373
NJ	$866	$586	$1,570	$61	$12,000	49	237	3,590
MD	$840	$511	$1,133	$351	$1,400	2 ⚠ thin data	19	43
SD	$839	$527	$1,293	$13	$5,411	23	99	758
NV	$810	$450	$1,943	$80	$28,516	27	267	1,205
FL	$804	$433	$1,974	<$1	$149,248	151	841	8,492
MN	$789	$606	$789	$40	$50,000	77	365	6,060
NY	$765	$473	$1,397	<$1	$35,000	112	417	8,107
IL	$740	$436	$1,038	$9	$7,440	104	483	4,220
VA	$716	$407	$1,688	$103	$7,166	49	77	1,507
NE	$696	$397	$1,198	$6	$7,273	44	131	1,863
KS	$692	$383	$1,082	$9	$159,060	74	347	2,030
ND	$663	$452	$897	$150	$2,620	22	69	550
MO	$656	$399	$1,106	$19	$7,801	45	214	3,003
SC	$646	$393	$1,245	$1	$15,483	47	168	2,104
OK	$646	$391	$762	$106	$5,617	63	240	2,031
MA	$638	$391	$1,118	$1	$13,614	43	425	2,571
CA	$627	$508	$1,467	<$1	$126,788	231	1,196	11,539
ID	$599	$406	$933	$54	$2,484	32	149	1,156
MT	$546	$529	$855	$53	$4,052	31	290	1,178
IA	$543	$351	$870	$18	$3,702	59	197	2,376
MS	$537	$334	$685	$4	$5,000	50	507	2,240
TN	$536	$379	$1,129	<$1	$4,936	69	204	3,956
NC	$532	$388	$620	$1	$5,070	59	174	3,172
PA	$512	$372	$1,242	$1	$25,414	93	317	4,996
VI	$506	$486	$550	$460	$591	1 ⚠ thin data	6	6
DE	$495	$453	$686	$417	$2,121	4	8	32
CT	$492	$383	$861	$35	$11,934	19	46	427
TX	$478	$359	$1,019	<$1	$22,109	283	677	12,806
LA	$476	$244	$908	$7	$17,881	58	414	3,857
UT	$470	$365	$654	$7	$6,405	37	153	2,649
RI	$468	$418	$822	$97	$2,567	9	34	220
NM	$454	$400	$706	$212	$4,145	15	60	245
DC	$448	$424	$558	$298	$6,265	4	18	72
AR	$440	$363	$899	$48	$12,793	38	343	1,495
ME	$431	$379	$924	$74	$3,998	28	34	662
AL	$430	$351	$922	$1	$34,567	47	229	1,337
IN	$430	$288	$706	$47	$4,580	59	337	3,204
AZ	$426	$347	$830	$56	$7,971	39	422	1,703
OH	$425	$370	$792	<$1	$11,143	90	366	3,735
VT	$422	$379	$570	<$1	$1,681	9	50	504
AS	$412	$385	$440	$385	$440	1 ⚠ thin data	1	6
WV	$394	$329	$530	$25	$2,792	22	99	628
KY	$376	$277	$572	$41	$5,703	53	137	1,682
MI	$364	$214	$496	<$1	$3,194	75	361	2,989
PR	$293	$293	$293	$249	$322	3	8	10