HIV-1 drug resistance testing, each additional drug 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

PHENOTYPE DNA HIV W/CLT ADD

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 $28 is 6% below the median hospital's median price ($30), higher than 46% of the 1,733 hospitals reporting CPT 87904. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 87904 at Southeast Texas - Jasper Memorial

Negotiated rates from the hospital’s own file: 8 payers, 24 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	$23	$23	—	—	—	$23 – $23
2	UnitedHealthcare hix fee schedule · outpatient	$23	$23	—	—	—	$23 – $23
3	UnitedHealthcare chip km fee schedule · outpatient	$26	$26	—	—	—	$26 – $26
4	UnitedHealthcare star kid km fee schedule · outpatient	$26	$26	—	—	—	$26 – $26
5	UnitedHealthcare star km fee schedule · outpatient	$26	$26	—	—	—	$26 – $26
6	UnitedHealthcare star plus km fee schedule · outpatient	$26	$26	—	—	—	$26 – $26
7	Molina chip km fee schedule · outpatient	$27	$27	—	—	—	$27 – $27
8	Molina star km fee schedule · outpatient	$27	$27	—	—	—	$27 – $27
9	Molina star plus km fee schedule · outpatient	$27	$27	—	—	—	$27 – $27
10	Aetna mm fee schedule · outpatient	$28	$28	—	—	—	$28 – $28
11	Bcbs Tx mm fee schedule · outpatient	$28	$28	—	—	—	$28 – $28
12	Humana gold choice mm fee schedule · outpatient	$28	$28	—	—	—	$28 – $28
13	Molina medicare adv mm fee schedule · outpatient	$28	$28	—	—	—	$28 – $28
14	UnitedHealthcare mm fee schedule · outpatient	$28	$28	—	—	—	$28 – $28
15	WellCare mm fee schedule · outpatient	$28	$28	—	—	—	$28 – $28
16	Devoted mm fee schedule · outpatient	$30	$30	—	—	—	$30 – $30
17	Humana choicecare fee schedule · outpatient	$82	$82	—	—	—	$82 – $82
18	Cigna new business fee schedule · outpatient	$122	$122	—	—	—	$122 – $122
19	Bcbs Tx blue advantage hmo fee schedule · outpatient	$141	$141	—	—	—	$141 – $141
20	Bcbs Tx heb fee schedule · outpatient	$155	$155	—	—	—	$155 – $155
21	Bcbs Tx hmo fee schedule · outpatient	$155	$155	—	—	—	$155 – $155
22	Cigna ppo fee schedule · outpatient	$156	$156	—	—	—	$156 – $156
23	Bcbs Tx ppo fee schedule · outpatient	$176	$176	—	—	—	$176 – $176
24	Bcbs Tx traditional fee schedule · outpatient	$183	$183	—	—	—	$183 – $183

Last updated: Jan 13, 2026

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See HIV-1 drug resistance testing, each additional drug pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.