Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Rpr Wnd Smpl f-m 12.6-20 ER
Low
$0
Average
$917
Median
$454
High
$17.8k
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Prices here combine facility and professional fees. See them separately →Experimental
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 342 hospitals; the 90th percentile is 12.3× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Pella Regional Health Center Pella, IA | $75 | $178 | $146 | 82% | 4–40 | $75 – $384 |
| 2 | Fairview Health Services Burnsville, MN | $150 | $150 | — | — | 2–20 | $150 – $150 |
| 3 | Boulder Community Health Boulder, CO | $180 | $180 | — | — | 2–20 | $180 – $180 |
| 4 | The Carle Foundation Hospital Urbana, IL | $111 | $111 | — | — | 2–20 | $111 – $111 |
| 5 | USA Health University Hospital Mobile, AL | $90 | $90 | — | — | 1–10 | $90 – $90 |
| 6 | Porter Hospital LLC Valparaiso, IN | $1.7k | $2.6k | $4.3k | 165% | 1–10 | $430 – $16.0k |
| 7 | Foley Hospital Company LLC Foley, AL | $386 | $420 | $112 | 27% | 1–10 | $258 – $625 |
| 8 | IOM Health System LP Fort Wayne, IN | $774 | $4.5k | $13.6k | 300% | 1–10 | $430 – $60.9k |
| 9 | Delta County Memorial Hospital DELTA, CO | $429 | $378 | $88 | 23% | 1–10 | $225 – $450 |
| 10 | Froedtert Community Hospital Pewaukee Pewaukee, WI | $159 | $159 | — | — | 1–10 | $159 – $159 |
Ask Claude or any MCP client for CPT 12016 pricing at a specific hospital — see how to connect.