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).

$642 National median

$400 – $1,080 IQR (p25 – p75)

2,894 hospitals filing

55 states

View hospital-by-hospital → Raw rate rows →

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Uninsured estimates use the cash / self-pay median for this code: $731.

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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
GU	$1,268	$1,268	$1,268
AK	$1,192	$724	$3,037
WY	$1,039	$594	$1,446
HI	$986	$493	$1,600
NH	$947	$416	$1,484
WI	$914	$814	$980
OR	$910	$549	$1,692
CO	$906	$457	$1,406
WA	$886	$488	$1,645
GA	$877	$426	$2,443
NJ	$869	$586	$1,570
MD	$840	$511	$1,133
SD	$839	$527	$1,293
FL	$804	$432	$1,972
NY	$792	$473	$1,478
NV	$790	$450	$1,943
MN	$789	$598	$789
IL	$724	$436	$1,032
VA	$712	$401	$1,600
MT	$686	$572	$1,052
KS	$680	$383	$1,087
ND	$676	$456	$897
NE	$659	$397	$1,198
MO	$656	$401	$1,107
OK	$646	$391	$800
CA	$627	$508	$1,512
MA	$617	$401	$1,118
SC	$602	$391	$1,183
ID	$599	$400	$909
IA	$550	$351	$870
TN	$549	$380	$1,134
MS	$537	$338	$688
NC	$532	$388	$612
PA	$511	$372	$1,234
VI	$506	$486	$550
UT	$500	$383	$657
DE	$495	$453	$686
CT	$492	$383	$861
TX	$471	$362	$1,006
LA	$468	$252	$908
RI	$468	$418	$822
NM	$454	$400	$706
DC	$448	$424	$558
ME	$444	$361	$953
IN	$443	$319	$680
AZ	$434	$347	$823
AL	$432	$354	$905
OH	$425	$370	$790
VT	$422	$379	$570
AS	$412	$385	$440
AR	$407	$349	$845
WV	$407	$331	$620
KY	$376	$279	$572
MI	$370	$214	$500
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

GU	$1,268	$1,268	$1,268	$1,268	$1,268	1 ⚠ thin data	4	4
AK	$1,192	$724	$3,037	$451	$15,448	7	29	92
WY	$1,039	$594	$1,446	$32	$2,613	21	100	394
HI	$986	$493	$1,600	$214	$4,720	15	31	307
NH	$947	$416	$1,484	$87	$7,243	15	45	596
WI	$914	$814	$980	$72	$16,897	92	522	6,092
OR	$910	$549	$1,692	$50	$13,592	37	405	2,646
CO	$906	$457	$1,406	$49	$9,888	69	268	2,920
WA	$886	$488	$1,645	$51	$16,508	68	229	3,137
GA	$877	$426	$2,443	$1	$50,000	80	180	2,446
NJ	$869	$586	$1,570	$61	$12,000	49	237	3,568
MD	$840	$511	$1,133	$351	$1,400	2 ⚠ thin data	19	43
SD	$839	$527	$1,293	$13	$5,411	23	99	758
FL	$804	$432	$1,972	<$1	$149,248	153	847	8,772
NY	$792	$473	$1,478	<$1	$35,000	116	432	8,308
NV	$790	$450	$1,943	$80	$6,461	26	263	1,160
MN	$789	$598	$789	$40	$50,000	77	368	6,099
IL	$724	$436	$1,032	$9	$7,440	106	510	4,355
VA	$712	$401	$1,600	$103	$7,166	49	77	1,578
MT	$686	$572	$1,052	$53	$4,052	31	290	1,194
KS	$680	$383	$1,087	$9	$159,060	73	349	2,038
ND	$676	$456	$897	$150	$2,620	22	72	579
NE	$659	$397	$1,198	$6	$7,273	45	137	1,947
MO	$656	$401	$1,107	$19	$7,801	46	214	3,051
OK	$646	$391	$800	$106	$5,617	64	240	2,060
CA	$627	$508	$1,512	<$1	$126,788	234	1,257	11,840
MA	$617	$401	$1,118	$1	$50,000	45	431	2,736
SC	$602	$391	$1,183	$1	$15,483	48	175	2,247
ID	$599	$400	$909	$54	$2,484	33	172	1,199
IA	$550	$351	$870	$18	$3,842	59	198	2,408
TN	$549	$380	$1,134	<$1	$4,936	71	209	4,013
MS	$537	$338	$688	$4	$4,350	50	499	2,270
NC	$532	$388	$612	$1	$5,070	59	178	3,280
PA	$511	$372	$1,234	$1	$27,015	94	321	5,148
VI	$506	$486	$550	$460	$591	1 ⚠ thin data	6	6
UT	$500	$383	$657	$7	$6,405	37	155	2,946
DE	$495	$453	$686	$417	$2,121	4	8	32
CT	$492	$383	$861	$35	$11,934	19	46	427
TX	$471	$362	$1,006	<$1	$22,109	287	761	13,305
LA	$468	$252	$908	$7	$17,881	60	429	3,947
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
ME	$444	$361	$953	$74	$3,998	28	34	636
IN	$443	$319	$680	$47	$4,706	61	346	3,600
AZ	$434	$347	$823	$56	$7,971	38	426	1,756
AL	$432	$354	$905	$1	$34,567	49	235	1,372
OH	$425	$370	$790	<$1	$11,143	93	391	3,779
VT	$422	$379	$570	<$1	$1,681	9	50	504
AS	$412	$385	$440	$385	$440	1 ⚠ thin data	1	6
AR	$407	$349	$845	$48	$12,793	39	338	1,482
WV	$407	$331	$620	$25	$2,792	23	100	610
KY	$376	$279	$572	$41	$5,703	54	138	1,641
MI	$370	$214	$500	<$1	$3,194	73	359	2,917
PR	$293	$293	$293	$249	$322	3	8	10