12-lead ECG generated from a reduced-lead recording 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

Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; tracing only

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 $64 is 2% below the median hospital's median price ($65), higher than 47% of the 983 hospitals reporting CPT 0904T. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 0904T 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	Aetna mm fee schedule · outpatient	$60	$60	—	—	—	$60 – $60
2	Bcbs Tx mm fee schedule · outpatient	$60	$60	—	—	—	$60 – $60
3	Humana gold choice mm fee schedule · outpatient	$60	$60	—	—	—	$60 – $60
4	Molina medicare adv mm fee schedule · outpatient	$60	$60	—	—	—	$60 – $60
5	UnitedHealthcare mm fee schedule · outpatient	$60	$60	—	—	—	$60 – $60
6	WellCare mm fee schedule · outpatient	$60	$60	—	—	—	$60 – $60
7	Devoted mm fee schedule · outpatient	$65	$65	—	—	—	$65 – $65
8	UnitedHealthcare hix fee schedule · outpatient	$78	$78	—	—	—	$78 – $78
9	UnitedHealthcare all payer fee schedule · outpatient	$224	$224	—	—	—	$224 – $224
10	Bcbs Tx blue advantage hmo fee schedule · outpatient	$321	$321	—	—	—	$321 – $321
11	Bcbs Tx heb fee schedule · outpatient	$352	$352	—	—	—	$352 – $352
12	Bcbs Tx hmo fee schedule · outpatient	$352	$352	—	—	—	$352 – $352
13	Bcbs Tx ppo fee schedule · outpatient	$402	$402	—	—	—	$402 – $402
14	Bcbs Tx traditional fee schedule · outpatient	$417	$417	—	—	—	$417 – $417

Last updated: Jan 13, 2026

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See 12-lead ECG generated from a reduced-lead recording pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.