Irritable bowel syndrome antibody blood test at Southeast Texas - Jasper Memorial

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

GI IBS IA ANTI-CDTB&VINCULIN

Jasper, TX

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Pricing by billing methodology

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How this price compares nationally

Southeast Texas - Jasper Memorial’s median price of $120 is 5% above the median hospital's median price ($114), higher than 70% of the 1,266 hospitals reporting CPT 0164U. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 0164U at Southeast Texas - Jasper Memorial

Negotiated rates from the hospital’s own file: 7 payers, 14 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Bcbs Tx blue advantage hmo fee schedule · outpatient	$93	$93	—	—	—	$93 – $93
2	UnitedHealthcare all payer fee schedule · outpatient	$101	$101	—	—	—	$101 – $101
3	UnitedHealthcare hix fee schedule · outpatient	$101	$101	—	—	—	$101 – $101
4	Bcbs Tx heb fee schedule · outpatient	$102	$102	—	—	—	$102 – $102
5	Bcbs Tx hmo fee schedule · outpatient	$102	$102	—	—	—	$102 – $102
6	Bcbs Tx ppo fee schedule · outpatient	$117	$117	—	—	—	$117 – $117
7	Aetna mm fee schedule · outpatient	$120	$120	—	—	—	$120 – $120
8	Bcbs Tx mm fee schedule · outpatient	$120	$120	—	—	—	$120 – $120
9	Humana gold choice mm fee schedule · outpatient	$120	$120	—	—	—	$120 – $120
10	Molina medicare adv mm fee schedule · outpatient	$120	$120	—	—	—	$120 – $120
11	UnitedHealthcare mm fee schedule · outpatient	$120	$120	—	—	—	$120 – $120
12	WellCare mm fee schedule · outpatient	$120	$120	—	—	—	$120 – $120
13	Bcbs Tx traditional fee schedule · outpatient	$121	$121	—	—	—	$121 – $121
14	Devoted mm fee schedule · outpatient	$130	$130	—	—	—	$130 – $130

Last updated: Jan 13, 2026

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