Injection behind the eyeball (Tenon's capsule) 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

INJECT/TREAT EYE SOCKET

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 $302 is 17% below the median hospital's median price ($363), higher than 34% of the 1,552 hospitals reporting CPT 67515. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 67515 at Southeast Texas - Jasper Memorial

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	$20	$20	—	—	—	$20 – $20
2	Molina star km fee schedule · outpatient	$20	$20	—	—	—	$20 – $20
3	Molina star plus km fee schedule · outpatient	$20	$20	—	—	—	$20 – $20
4	UnitedHealthcare chip km fee schedule · outpatient	$36	$36	—	—	—	$36 – $36
5	UnitedHealthcare star kid km fee schedule · outpatient	$36	$36	—	—	—	$36 – $36
6	UnitedHealthcare star km fee schedule · outpatient	$36	$36	—	—	—	$36 – $36
7	UnitedHealthcare star plus km fee schedule · outpatient	$36	$36	—	—	—	$36 – $36
8	Bcbs Tx heb fee schedule · outpatient	$53	$53	—	—	—	$53 – $53
9	Bcbs Tx blue advantage hmo fee schedule · outpatient	$85	$85	—	—	—	$85 – $85
10	Bcbs Tx hmo fee schedule · outpatient	$90	$90	—	—	—	$90 – $90
11	Bcbs Tx ppo fee schedule · outpatient	$109	$109	—	—	—	$109 – $109
12	Bcbs Tx traditional fee schedule · outpatient	$126	$126	—	—	—	$126 – $126
13	Humana choicecare other · outpatient	$173	$173	—	—	—	$173 – $173
14	Aetna mm fee schedule · outpatient	$302	$302	—	—	—	$302 – $302
15	Bcbs Tx mm fee schedule · outpatient	$302	$302	—	—	—	$302 – $302
16	Humana gold choice mm fee schedule · outpatient	$302	$302	—	—	—	$302 – $302
17	Molina medicare adv mm fee schedule · outpatient	$302	$302	—	—	—	$302 – $302
18	UnitedHealthcare mm fee schedule · outpatient	$302	$302	—	—	—	$302 – $302
19	WellCare mm fee schedule · outpatient	$302	$302	—	—	—	$302 – $302
20	Devoted mm fee schedule · outpatient	$326	$326	—	—	—	$326 – $326
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	$1.7k	$1.7k	—	—	—	$1.7k – $1.7k
24	Aetna epo case rate · outpatient	$1.9k	$1.9k	—	—	—	$1.9k – $1.9k
25	Aetna hmo case rate · outpatient	$1.9k	$1.9k	—	—	—	$1.9k – $1.9k

Page 1 of 2 · 29 rates

Last updated: Jan 13, 2026

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