CHRISTUS Southeast Texas Jasper Memorial
1275 Marvin Hancock Dr, Jasper, TX · Christushealth · · NPI 1598749707
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Derm-maxx, per sq cm HCPCS Q4238 | not published | not published | $91.56 – $1,644.99 | 2 |
| Descend thora aorta rpr/lt sub art 33880 CPT 33880 | not published | not published | $2,774.10 – $4,989.00 | 3 |
| Description not available HCPCS S0013 | not published | not published | $529.20 – $529.20 | 1 |
| Design custom breast implant CPT 19396 | not published | not published | $963.66 – $7,725.92 | 28 |
| Design mlc device for imrt CPT 77338 | not published | not published | $184.65 – $1,045.93 | 26 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | not published | not published | $4.49 – $9.98 | 25 |
| Desoxycorticosterone CPT 82633 | not published | not published | $16.59 – $167.29 | 29 |
| Des thora aorta/ea add prox prosth 33884 CPT 33884 | not published | not published | $608.59 – $4,989.00 | 3 |
| Des thora aorta rpr without left sub art 33881 CPT 33881 | not published | not published | $2,381.01 – $4,989.00 | 3 |
| Des thor aorta/prox ext prosth/ini 33883 CPT 33883 | not published | not published | $1,723.87 – $4,989.00 | 3 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | not published | not published | $74.34 – $4,989.00 | 28 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | not published | not published | $200.45 – $4,989.00 | 26 |
| Destroy cervthor facet jnt 64633 CPT 64633 | not published | not published | $659.94 – $4,989.00 | 28 |
| Destroy cth facet jnt addl 64634 CPT 64634 | not published | not published | $475.00 – $4,989.00 | 2 |
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $709.01 – $4,989.00 | 28 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $215.94 – $4,989.00 | 28 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | not published | not published | $143.08 – $4,989.00 | 28 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | not published | not published | $280.45 – $4,989.00 | 28 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $146.78 – $4,989.00 | 28 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $939.93 – $5,533.02 | 28 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | not published | not published | $126.93 – $4,989.00 | 28 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $340.77 – $4,989.00 | 28 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | not published | not published | $1,370.00 – $4,989.00 | 2 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | not published | not published | $659.94 – $4,989.00 | 28 |
| Destruction ciliary body CPT 66700 | not published | not published | $849.94 – $4,989.00 | 28 |
| Destruction ciliary body CPT 66720 | not published | not published | $698.30 – $4,989.00 | 28 |
| Destruction ciliary body CPT 66740 | not published | not published | $698.30 – $4,989.00 | 28 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $66.43 – $4,989.00 | 28 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $939.93 – $5,533.02 | 28 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $69.21 – $4,989.00 | 28 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $107.42 – $4,989.00 | 28 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $120.15 – $4,989.00 | 28 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $109.08 – $4,989.00 | 28 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $120.15 – $4,989.00 | 28 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $217.00 – $4,989.00 | 26 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $709.01 – $4,989.00 | 28 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $939.93 – $5,533.02 | 28 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $1,063.52 – $6,415.00 | 28 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $98.83 – $6,415.00 | 28 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $57.10 – $4,989.00 | 28 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $16.08 – $162.16 | 29 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $23.39 – $235.82 | 29 |
| Determination venous press CPT 93770 | not published | not published | $18.47 – $1,542.00 | 3 |
| Determine refractive state CPT 92015 | not published | not published | $44.97 – $87.41 | 2 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $157.84 – $610.12 | 25 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | not published | not published | $11.87 – $11.87 | 1 |
| Device intraute mirena HCPCS J7298 | not published | not published | $1,457.56 – $4,008.56 | 3 |
| Dev interrog remote 1/2/mlt CPT 93295 | not published | not published | $153.89 – $1,542.00 | 3 |
| Devise bowel pouch CPT 44316 | not published | not published | $2,191.13 – $4,989.00 | 3 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | not published | not published | $262.22 – $262.22 | 1 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $110.68 – $594.07 | 25 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $2.71 – $5.25 | 2 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $4.75 | $14.40 | $0.04 – $0.18 | 4 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $40.63 | $123.13 | $0.09 – $0.28 | 4 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $204.68 – $840.06 | 27 |
| Dexamethasone panel CPT 80420 | not published | not published | $86.69 – $874.15 | 29 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $0.64 – $2.60 | 25 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $80.96 – $835.96 | 25 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $48.92 – $117.00 | 3 |
| Dextran 75 infusion HCPCS J7110 | not published | not published | $33.40 – $33.40 | 1 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $0.76 – $5.51 | 2 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | not published | not published | $1.25 – $7.41 | 4 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $48.39 | $146.65 | $2.71 – $21.83 | 3 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $96.79 | $293.30 | $1.82 – $33.43 | 4 |
| Dextrose 5 % IV bolus HCPCS J7070 | $48.39 | $146.65 | $3.64 – $66.86 | 4 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $30.05 – $120.57 | 25 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $219.35 – $488.31 | 2 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $35.17 – $80.29 | 2 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $35.17 – $80.29 | 2 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $35.17 – $80.29 | 2 |
| Diab manage trn ind/group HCPCS G0109 | not published | not published | $32.80 – $214.00 | 3 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $73.13 – $162.79 | 2 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $35.17 – $80.29 | 2 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $525.71 – $3,479.28 | 28 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $1,888.85 – $11,771.36 | 28 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $161.36 – $3,215.00 | 26 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $1,189.45 – $3,215.00 | 26 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $44.41 – $351.96 | 28 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | not published | not published | $2,885.00 – $4,989.00 | 2 |
| Dialysis one evaluation CPT 90945 | not published | not published | $429.57 – $859.14 | 24 |
| Dialysis repeated eval CPT 90947 | not published | not published | $653.00 – $653.00 | 1 |
| Diathermy eg microwave CPT 97024 | not published | not published | $31.80 – $245.00 | 5 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.08 – $0.40 | 3 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $100.71 | $305.17 | $5.79 – $27.34 | 4 |
| Dicyclomine injection HCPCS J0500 | $171.58 | $519.95 | $12.86 – $172.36 | 4 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.09 – $0.79 | 25 |
| Diffusing capacity CPT 94729 | not published | not published | $74.00 – $206.61 | 3 |
| Digital analysis of eeg CPT 95957 | not published | not published | $595.00 – $742.20 | 3 |
| Digit nerve surgery add-on CPT 64778 | not published | not published | $2,040.00 – $4,989.00 | 2 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $25.40 | $76.96 | $4.88 – $19.32 | 4 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $4,968.58 – $16,850.61 | 25 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | not published | not published | $73.46 – $856.07 | 4 |
| Dilate biliary duct/ampulla CPT 47542 | not published | not published | $2,885.00 – $4,989.00 | 2 |
| Dilate esophagus CPT 43453 | not published | not published | $564.97 – $4,989.00 | 28 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $334.95 – $4,989.00 | 28 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $524.84 – $4,989.00 | 3 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $262.42 – $4,989.00 | 3 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $747.27 – $4,989.00 | 3 |
| Dilate tear duct opening CPT 68801 | not published | not published | $173.00 – $4,989.00 | 26 |
| Dilate urethra stricture CPT 53600 | not published | not published | $34.88 – $4,989.00 | 28 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.