Orbital venogram imaging with radiologist review 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

VEIN X-RAY EYE SOCKET

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 $686 is 7% above the median hospital's median price ($644), higher than 58% of the 1,442 hospitals reporting CPT 75880. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 75880 at Southeast Texas - Jasper Memorial

Negotiated rates from the hospital’s own file: 8 payers, 22 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	UnitedHealthcare chip km fee schedule · outpatient	$119	$119	—	—	—	$119 – $119
2	UnitedHealthcare star kid km fee schedule · outpatient	$119	$119	—	—	—	$119 – $119
3	UnitedHealthcare star km fee schedule · outpatient	$119	$119	—	—	—	$119 – $119
4	UnitedHealthcare star plus km fee schedule · outpatient	$119	$119	—	—	—	$119 – $119
5	Humana choicecare fee schedule · outpatient	$322	$322	—	—	—	$322 – $322
6	Cigna new business fee schedule · outpatient	$380	$380	—	—	—	$380 – $380
7	Cigna ppo fee schedule · outpatient	$487	$487	—	—	—	$487 – $487
8	Aetna mm fee schedule · outpatient	$624	$624	—	—	—	$624 – $624
9	Bcbs Tx mm fee schedule · outpatient	$624	$624	—	—	—	$624 – $624
10	Humana gold choice mm fee schedule · outpatient	$624	$624	—	—	—	$624 – $624
11	Molina medicare adv mm fee schedule · outpatient	$624	$624	—	—	—	$624 – $624
12	UnitedHealthcare mm fee schedule · outpatient	$624	$624	—	—	—	$624 – $624
13	WellCare mm fee schedule · outpatient	$624	$624	—	—	—	$624 – $624
14	Devoted mm fee schedule · outpatient	$674	$674	—	—	—	$674 – $674
15	Molina chip km fee schedule · outpatient	$765	$765	—	—	—	$765 – $765
16	Molina star km fee schedule · outpatient	$765	$765	—	—	—	$765 – $765
17	Molina star plus km fee schedule · outpatient	$765	$765	—	—	—	$765 – $765
18	Bcbs Tx blue advantage hmo fee schedule · outpatient	$2.8k	$2.8k	—	—	—	$2.8k – $2.8k
19	Bcbs Tx heb fee schedule · outpatient	$3.1k	$3.1k	—	—	—	$3.1k – $3.1k
20	Bcbs Tx hmo fee schedule · outpatient	$3.1k	$3.1k	—	—	—	$3.1k – $3.1k
21	Bcbs Tx ppo fee schedule · outpatient	$3.5k	$3.5k	—	—	—	$3.5k – $3.5k
22	Bcbs Tx traditional fee schedule · outpatient	$3.6k	$3.6k	—	—	—	$3.6k – $3.6k

Last updated: Jan 13, 2026

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