Esophageal reflux test using wireless pH monitoring 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

G-ESOPH REFLX TST W/ELECTROD

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 $583 is 38% below the median hospital's median price ($940), higher than 24% of the 1,917 hospitals reporting CPT 91035. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 91035 at Southeast Texas - Jasper Memorial

Negotiated rates from the hospital’s own file: 7 payers, 20 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	Aetna mm fee schedule · outpatient	$535	$535	—	—	—	$535 – $535
2	Bcbs Tx mm fee schedule · outpatient	$535	$535	—	—	—	$535 – $535
3	Humana gold choice mm fee schedule · outpatient	$535	$535	—	—	—	$535 – $535
4	Molina medicare adv mm fee schedule · outpatient	$535	$535	—	—	—	$535 – $535
5	UnitedHealthcare mm fee schedule · outpatient	$535	$535	—	—	—	$535 – $535
6	WellCare mm fee schedule · outpatient	$535	$535	—	—	—	$535 – $535
7	Devoted mm fee schedule · outpatient	$578	$578	—	—	—	$578 – $578
8	UnitedHealthcare hix case rate · outpatient	$599	$599	—	—	—	$599 – $599
9	Humana choicecare fee schedule · outpatient	$1.0k	$1.0k	—	—	—	$1.0k – $1.0k
10	UnitedHealthcare all payer case rate · outpatient	$1.3k	$1.3k	—	—	—	$1.3k – $1.3k
11	Bcbs Tx blue advantage hmo fee schedule · outpatient	$1.8k	$1.8k	—	—	—	$1.8k – $1.8k
12	Bcbs Tx heb fee schedule · outpatient	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
13	Bcbs Tx hmo fee schedule · outpatient	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
14	Bcbs Tx ppo fee schedule · outpatient	$2.3k	$2.3k	—	—	—	$2.3k – $2.3k
15	Bcbs Tx traditional fee schedule · outpatient	$2.3k	$2.3k	—	—	—	$2.3k – $2.3k
16	Aetna new business case rate · outpatient	$3.7k	$3.7k	—	—	—	$3.7k – $3.7k
17	Aetna epo case rate · outpatient	$4.1k	$4.1k	—	—	—	$4.1k – $4.1k
18	Aetna hmo case rate · outpatient	$4.1k	$4.1k	—	—	—	$4.1k – $4.1k
19	Aetna pos case rate · outpatient	$4.1k	$4.1k	—	—	—	$4.1k – $4.1k
20	Aetna ppo case rate · outpatient	$4.1k	$4.1k	—	—	—	$4.1k – $4.1k

Last updated: Jan 13, 2026

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