Breast CT scan without contrast dye 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

CT BREAST W/3D UNI C-

Jasper, TX

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Pricing by billing methodology

Price type

How this price compares nationally

Southeast Texas - Jasper Memorial’s median price of $118 is 21% below the median hospital's median price ($149), higher than 37% of the 1,258 hospitals reporting CPT 0633T. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 0633T at Southeast Texas - Jasper Memorial

Negotiated rates from the hospital’s own file: 9 payers, 23 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	Aetna mm fee schedule · outpatient	$107	$107	—	—	—	$107 – $107
2	Bcbs Tx mm fee schedule · outpatient	$107	$107	—	—	—	$107 – $107
3	Humana gold choice mm fee schedule · outpatient	$107	$107	—	—	—	$107 – $107
4	Molina medicare adv mm fee schedule · outpatient	$107	$107	—	—	—	$107 – $107
5	UnitedHealthcare mm fee schedule · outpatient	$107	$107	—	—	—	$107 – $107
6	WellCare mm fee schedule · outpatient	$107	$107	—	—	—	$107 – $107
7	Devoted mm fee schedule · outpatient	$116	$116	—	—	—	$116 – $116
8	UnitedHealthcare hix fee schedule · outpatient	$425	$425	—	—	—	$425 – $425
9	Bcbs Tx blue advantage hmo fee schedule · outpatient	$481	$481	—	—	—	$481 – $481
10	Bcbs Tx heb fee schedule · outpatient	$529	$529	—	—	—	$529 – $529
11	Bcbs Tx hmo fee schedule · outpatient	$529	$529	—	—	—	$529 – $529
12	Bcbs Tx ppo fee schedule · outpatient	$605	$605	—	—	—	$605 – $605
13	Bcbs Tx traditional fee schedule · outpatient	$623	$623	—	—	—	$623 – $623
14	Aetna new business per diem · outpatient	$847	$847	—	—	—	$847 – $847
15	Cigna new business fee schedule · outpatient	$858	$858	—	—	—	$858 – $858
16	Aetna epo per diem · outpatient	$940	$940	—	—	—	$940 – $940
17	Aetna hmo per diem · outpatient	$940	$940	—	—	—	$940 – $940
18	Aetna pos per diem · outpatient	$940	$940	—	—	—	$940 – $940
19	Aetna ppo per diem · outpatient	$940	$940	—	—	—	$940 – $940
20	Healthcare Highways ppo other · outpatient	$988	$988	—	—	—	$988 – $988
21	Cigna ppo fee schedule · outpatient	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
22	Humana choicecare fee schedule · outpatient	$1.2k	$1.2k	—	—	—	$1.2k – $1.2k
23	UnitedHealthcare all payer fee schedule · outpatient	$1.2k	$1.2k	—	—	—	$1.2k – $1.2k

Last updated: Jan 13, 2026

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See Breast CT scan without contrast dye pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.