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
DSTRJ MAL LES T/A/L >4.0 CM
Jasper, TX
See all hospitals reporting CPT 17266 →Price type
Southeast Texas - Jasper Memorial’s median price of $403 is 17% below the median hospital's median price ($484), higher than 34% of the 1,668 hospitals reporting CPT 17266. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 29 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 | Molina chip km fee schedule · outpatient | $126 | $126 | — | — | — | $126 – $126 |
| 2 | Molina star km fee schedule · outpatient | $126 | $126 | — | — | — | $126 – $126 |
| 3 | Molina star plus km fee schedule · outpatient | $126 | $126 | — | — | — | $126 – $126 |
| 4 | Bcbs Tx heb fee schedule · outpatient | $215 | $215 | — | — | — | $215 – $215 |
| 5 | Bcbs Tx blue advantage hmo fee schedule · outpatient | $343 | $343 | — | — | — | $343 – $343 |
| 6 | Bcbs Tx hmo fee schedule · outpatient | $362 | $362 | — | — | — | $362 – $362 |
| 7 | UnitedHealthcare chip km case rate · outpatient | $382 | $382 | — | — | — | $382 – $382 |
| 8 | UnitedHealthcare star kid km case rate · outpatient | $382 | $382 | — | — | — | $382 – $382 |
| 9 | UnitedHealthcare star km case rate · outpatient | $382 | $382 | — | — | — | $382 – $382 |
| 10 | UnitedHealthcare star plus km case rate · outpatient | $382 | $382 | — | — | — | $382 – $382 |
| 11 | Aetna mm fee schedule · outpatient | $403 | $403 | — | — | — | $403 – $403 |
| 12 | Bcbs Tx mm fee schedule · outpatient | $403 | $403 | — | — | — | $403 – $403 |
| 13 | Humana gold choice mm fee schedule · outpatient | $403 | $403 | — | — | — | $403 – $403 |
| 14 | Molina medicare adv mm fee schedule · outpatient | $403 | $403 | — | — | — | $403 – $403 |
| 15 | UnitedHealthcare mm fee schedule · outpatient | $403 | $403 | — | — | — | $403 – $403 |
| 16 | WellCare mm fee schedule · outpatient | $403 | $403 | — | — | — | $403 – $403 |
| 17 | Devoted mm fee schedule · outpatient | $435 | $435 | — | — | — | $435 – $435 |
| 18 | Bcbs Tx ppo fee schedule · outpatient | $441 | $441 | — | — | — | $441 – $441 |
| 19 | Humana choicecare other · outpatient | $488 | $488 | — | — | — | $488 – $488 |
| 20 | Bcbs Tx traditional fee schedule · outpatient | $506 | $506 | — | — | — | $506 – $506 |
| 21 | UnitedHealthcare hix case rate · outpatient | $599 | $599 | — | — | — | $599 – $599 |
| 22 | UnitedHealthcare all payer case rate · outpatient | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 23 | Aetna new business case rate · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 24 | Aetna epo case rate · outpatient | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 25 | Aetna hmo case rate · outpatient | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
Last updated: Jan 13, 2026
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