Stomach electrical activity test with provocation 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

ELECTROGASTROGRAPHY W/TEST

Jasper, TX

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How this price compares nationally

Southeast Texas - Jasper Memorial’s median price of $139 is 33% below the median hospital's median price ($209), higher than 26% of the 1,302 hospitals reporting CPT 91133. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 91133 at Southeast Texas - Jasper Memorial

Negotiated rates from the hospital’s own file: 7 payers, 15 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	$130	$130	—	—	—	$130 – $130
2	Bcbs Tx mm fee schedule · outpatient	$130	$130	—	—	—	$130 – $130
3	Humana gold choice mm fee schedule · outpatient	$130	$130	—	—	—	$130 – $130
4	Molina medicare adv mm fee schedule · outpatient	$130	$130	—	—	—	$130 – $130
5	UnitedHealthcare mm fee schedule · outpatient	$130	$130	—	—	—	$130 – $130
6	WellCare mm fee schedule · outpatient	$130	$130	—	—	—	$130 – $130
7	Devoted mm fee schedule · outpatient	$140	$140	—	—	—	$140 – $140
8	Humana choicecare fee schedule · outpatient	$375	$375	—	—	—	$375 – $375
9	Bcbs Tx blue advantage hmo fee schedule · outpatient	$481	$481	—	—	—	$481 – $481
10	Bcbs Tx heb fee schedule · outpatient	$529	$529	—	—	—	$529 – $529
11	Bcbs Tx hmo fee schedule · outpatient	$529	$529	—	—	—	$529 – $529
12	UnitedHealthcare hix case rate · outpatient	$599	$599	—	—	—	$599 – $599
13	Bcbs Tx ppo fee schedule · outpatient	$605	$605	—	—	—	$605 – $605
14	Bcbs Tx traditional fee schedule · outpatient	$624	$624	—	—	—	$624 – $624
15	UnitedHealthcare all payer case rate · outpatient	$1.3k	$1.3k	—	—	—	$1.3k – $1.3k

Last updated: Jan 13, 2026

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