Silver diamine fluoride dental treatment 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

APPL SLVR DIAMN FLUORIDE 38%

Jasper, TX

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How this price compares nationally

Southeast Texas - Jasper Memorial’s median price of $51 is about the same as the median hospital's median price ($51), higher than 47% of the 237 hospitals reporting CPT 0792T. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 0792T at Southeast Texas - Jasper Memorial

Negotiated rates from the hospital’s own file: 1 payer, 5 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	$46	$46	—	—	—	$46 – $46
2	Bcbs Tx heb fee schedule · outpatient	$51	$51	—	—	—	$51 – $51
3	Bcbs Tx hmo fee schedule · outpatient	$51	$51	—	—	—	$51 – $51
4	Bcbs Tx ppo fee schedule · outpatient	$58	$58	—	—	—	$58 – $58
5	Bcbs Tx traditional fee schedule · outpatient	$60	$60	—	—	—	$60 – $60

Last updated: Jan 13, 2026

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