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 |
|---|---|---|---|---|
| Drainage of urinary leakage CPT 53085 | not published | not published | $2,066.53 – $4,989.00 | 26 |
| Drain bladder by trocar/cath CPT 51101 | not published | not published | $98.83 – $4,989.00 | 28 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | not published | not published | $486.45 – $4,989.00 | 28 |
| Drain cath image guided visceral pq CPT 49405 | not published | not published | $1,634.49 – $4,989.00 | 26 |
| Drain chest lesion CPT 21502 | not published | not published | $1,088.27 – $6,546.30 | 28 |
| Drain chst dry seal exp thorastat HCPCS A7041 | not published | not published | $195.68 – $195.68 | 1 |
| Drain lower leg bursa CPT 27604 | not published | not published | $1,088.27 – $6,546.30 | 28 |
| Drain lower leg lesion 27603 CPT 27603 | not published | not published | $815.20 – $5,774.46 | 28 |
| Drain neck/chest lesion 21501 CPT 21501 | not published | not published | $815.20 – $5,774.46 | 28 |
| Drain open lung lesion 32200 CPT 32200 | not published | not published | $1,746.28 – $4,989.00 | 3 |
| Drain ostomy pouch w/flange HCPCS A5063 | not published | not published | $3.11 – $6.92 | 2 |
| Drain ovarn cyst abd CPT 58805 | not published | not published | $1,063.52 – $6,415.00 | 28 |
| Drain ovary abscess open CPT 58820 | not published | not published | $1,063.52 – $6,415.00 | 28 |
| Drain pancreatic pseudocyst 48510 CPT 48510 | not published | not published | $1,695.61 – $4,989.00 | 3 |
| Drain penis lesion CPT 54015 | not published | not published | $486.45 – $4,989.00 | 28 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $593.04 – $4,989.00 | 28 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $815.20 – $5,774.46 | 28 |
| Drain shoulder lesion CPT 23030 | not published | not published | $815.20 – $5,774.46 | 28 |
| Drain thigh/knee lesion 27301 CPT 27301 | not published | not published | $815.20 – $5,774.46 | 28 |
| Drain thyroid/tongue cyst CPT 60000 | not published | not published | $420.64 – $4,989.00 | 28 |
| Drain to peritoneal cavity CPT 49062 | not published | not published | $1,140.90 – $4,989.00 | 3 |
| Dressing change not for burn w/anes 15852 CPT 15852 | not published | not published | $173.00 – $4,989.00 | 26 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | not published | not published | $50.48 – $171.90 | 3 |
| Drill hole evac+/drg subdural hematoma 61108 CPT 61108 | not published | not published | $1,388.39 – $4,989.00 | 3 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | not published | not published | $490.71 – $4,989.00 | 3 |
| Driver pneumatic vad, rep HCPCS Q0480 | not published | not published | $200,311.92 – $200,311.92 | 1 |
| Drm agrft f/s/n/h/f/g/m ea CPT 15136 | not published | not published | $1,526.00 – $4,989.00 | 2 |
| Drm agrft t/a/l ea addl CPT 15131 | not published | not published | $1,526.00 – $4,989.00 | 2 |
| Drng appendix abscess open 44900 CPT 44900 | not published | not published | $1,195.31 – $4,989.00 | 3 |
| Drng hand tendon sheath 26020 CPT 26020 | not published | not published | $1,088.27 – $6,546.30 | 28 |
| Drng of hydrocele 55000 CPT 55000 | not published | not published | $50.47 – $4,989.00 | 28 |
| Drng of mouth lesion 40801 CPT 40801 | not published | not published | $187.22 – $4,989.00 | 28 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $1,063.52 – $6,415.00 | 28 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $1,088.27 – $6,546.30 | 28 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $1,088.27 – $6,546.30 | 28 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $429.26 – $4,989.00 | 28 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $886.62 – $6,543.20 | 28 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | not published | not published | $1,526.00 – $4,989.00 | 3 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $1,541.46 – $4,989.00 | 3 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $1,056.62 – $4,989.00 | 3 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $2,460.47 – $4,989.00 | 3 |
| Drng salivary gland simple 42300 CPT 42300 | not published | not published | $420.64 – $4,989.00 | 28 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $187.22 – $4,989.00 | 28 |
| Dronabinol 2.5mg oral HCPCS Q0167 | not published | not published | $1.48 – $9.80 | 4 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $49.10 | $148.79 | $5.87 – $8.57 | 3 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | not published | not published | $6.79 – $22.29 | 3 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | not published | not published | $12.01 – $51.69 | 3 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | not published | not published | $9.09 – $2,885.00 | 2 |
| Drsg sht 5.625x4.625in std HCPCS A6025 | not published | not published | $37.58 – $37.58 | 1 |
| Drsg surg adh 11x11 3/4 occl drap wnd 28x30 HCPCS A6259 | not published | not published | $12.57 – $28.01 | 2 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | not published | not published | $13.18 – $89.92 | 2 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | not published | not published | $29.93 – $84.19 | 2 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | not published | not published | $49.79 – $177.37 | 3 |
| Drsg wound/burn 18x10cm suprathel resorb cost per sq cm HCPCS A2012 | not published | not published | $0.55 – $0.55 | 1 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | not published | not published | $9.38 – $80.54 | 2 |
| Drug admin & hemodynmic meas CPT 93463 | not published | not published | $448.19 – $15,931.00 | 3 |
| Drug assay caffeine CPT 80155 | not published | not published | $20.66 – $208.28 | 29 |
| Drug assay posaconazole CPT 80187 | not published | not published | $14.52 – $146.39 | 28 |
| Drug assay rufinamide CPT 80210 | not published | not published | $14.52 – $146.39 | 27 |
| Drug assay vedolizumab CPT 80280 | not published | not published | $20.66 – $208.28 | 28 |
| Drug assay voriconazole CPT 80285 | not published | not published | $14.52 – $146.39 | 28 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $9.98 – $100.66 | 27 |
| Drug screening tapentadol CPT 80372 | not published | not published | $11.47 – $52.92 | 7 |
| Drug screen quant tiagabine CPT 80199 | not published | not published | $14.52 – $146.39 | 29 |
| Drug/substance nos 4-6 CPT 80376 | not published | not published | $20.29 – $52.92 | 7 |
| Drug test def 15-21 classes HCPCS G0482 | not published | not published | $178.87 – $1,073.20 | 29 |
| Drug test def 22+ classes HCPCS G0483 | not published | not published | $222.23 – $1,333.37 | 29 |
| Drug test def 8-14 classes HCPCS G0481 | not published | not published | $140.93 – $845.59 | 29 |
| Drug test def simple all cl HCPCS G0659 | not published | not published | $55.93 – $335.56 | 29 |
| Drug test prsmv instrmnt CPT 80306 | not published | not published | $9.18 – $92.56 | 29 |
| Dry needling (97799) CPT 97799 | not published | not published | $74.00 – $245.00 | 4 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $133.72 – $7,608.34 | 28 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | not published | not published | $140.72 – $4,989.00 | 28 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $133.72 – $4,989.00 | 28 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $117.10 – $4,989.00 | 28 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $128.74 – $4,989.00 | 28 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $153.38 – $4,989.00 | 28 |
| Dstry eye lesn,fdr vssl tech HCPCS G0186 | not published | not published | $208.33 – $1,106.86 | 27 |
| Duodenal exclusion CPT 48547 | not published | not published | $2,768.24 – $4,989.00 | 3 |
| Duodenal motility study CPT 91022 | not published | not published | $371.22 – $1,070.54 | 25 |
| Duplex scan bilateral study 93985 CPT 93985 | not published | not published | $243.85 – $1,021.93 | 25 |
| Duplex scan unilateral study 93986 CPT 93986 | not published | not published | $107.28 – $581.68 | 25 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | not published | not published | $83.87 – $328.02 | 25 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | not published | not published | $74.00 – $315.68 | 24 |
| Dx aly aud oi snd prcsr each CPT 92623 | not published | not published | $74.00 – $74.00 | 1 |
| Dx bronchoscope/brush 31623 CPT 31623 | not published | not published | $525.71 – $3,479.28 | 28 |
| Dx bronchoscope/lavage 31624 CPT 31624 | not published | not published | $525.71 – $3,479.28 | 28 |
| Dx bronchoscope/wash 31622 CPT 31622 | not published | not published | $525.71 – $3,479.28 | 28 |
| Dx dark adaptation exam i&r CPT 92284 | not published | not published | $136.94 – $1,603.43 | 25 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $173.00 – $4,989.00 | 26 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $173.00 – $4,989.00 | 28 |
| Dx gastr intub w/asp spec CPT 43754 | not published | not published | $173.00 – $4,989.00 | 26 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $157.84 – $4,989.00 | 26 |
| Dx intraop epcar Ultrasound chd i&r CPT 76989 | not published | not published | $113.00 – $156.91 | 2 |
| Dx intraop epicar car Ultrasound chd CPT 76987 | not published | not published | $113.00 – $419.92 | 2 |
| Dx intraop thoracic aorta Ultrasound CPT 76984 | not published | not published | $113.00 – $137.50 | 2 |
| Dx laryngoscopy newborn CPT 31520 | not published | not published | $155.59 – $4,989.00 | 28 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $525.71 – $4,989.00 | 28 |
| Dx ntrop epcr Ultrasound chd img acq CPT 76988 | not published | not published | $113.00 – $267.51 | 2 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $95.61 – $4,989.00 | 26 |
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.