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
OB PE KDR ENG&RBP4 IA ALG
Jasper, TX
See all hospitals reporting CPT 0390U →Price type
Southeast Texas - Jasper Memorial’s median price of $71 is 7% above the median hospital's median price ($66), higher than 72% of the 1,234 hospitals reporting CPT 0390U. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
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 | UnitedHealthcare all payer fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 2 | UnitedHealthcare hix fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 3 | Aetna mm fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 4 | Bcbs Tx mm fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 5 | Humana gold choice mm fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 6 | Molina medicare adv mm fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 7 | UnitedHealthcare mm fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 8 | WellCare mm fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 9 | Devoted mm fee schedule · outpatient | $75 | $75 | — | — | — | $75 – $75 |
| 10 | Bcbs Tx blue advantage hmo fee schedule · outpatient | $172 | $172 | — | — | — | $172 – $172 |
| 11 | Bcbs Tx heb fee schedule · outpatient | $189 | $189 | — | — | — | $189 – $189 |
| 12 | Bcbs Tx hmo fee schedule · outpatient | $189 | $189 | — | — | — | $189 – $189 |
| 13 | Bcbs Tx ppo fee schedule · outpatient | $215 | $215 | — | — | — | $215 – $215 |
| 14 | Bcbs Tx traditional fee schedule · outpatient | $223 | $223 | — | — | — | $223 – $223 |
Last updated: Jan 13, 2026
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