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
AQUAPORIN-4 ANTB CBA EACH
Jasper, TX
See all hospitals reporting CPT 86052 →Price type
Southeast Texas - Jasper Memorial’s median price of $13 is 13% below the median hospital's median price ($15), higher than 42% of the 1,967 hospitals reporting CPT 86052. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 17 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 all payer fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 2 | UnitedHealthcare hix fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 3 | Molina chip km fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 4 | Molina star km fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 5 | Molina star plus km fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 6 | Aetna mm fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 7 | Bcbs Tx mm fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 8 | Humana gold choice mm fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 9 | Molina medicare adv mm fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 10 | UnitedHealthcare mm fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 11 | WellCare mm fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 12 | Devoted mm fee schedule · outpatient | $14 | $14 | — | — | — | $14 – $14 |
| 13 | Bcbs Tx blue advantage hmo fee schedule · outpatient | $65 | $65 | — | — | — | $65 – $65 |
| 14 | Bcbs Tx heb fee schedule · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 15 | Bcbs Tx hmo fee schedule · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 16 | Bcbs Tx ppo fee schedule · outpatient | $81 | $81 | — | — | — | $81 – $81 |
| 17 | Bcbs Tx traditional fee schedule · outpatient | $85 | $85 | — | — | — | $85 – $85 |
Last updated: Jan 13, 2026
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