Eye imaging with indocyanine green dye 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

ICG ANGIOGRAPHY I&R UNI/BI

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 $330 is 9% above the median hospital's median price ($302), higher than 63% of the 1,279 hospitals reporting CPT 92240. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 92240 at Southeast Texas - Jasper Memorial

Negotiated rates from the hospital’s own file: 7 payers, 13 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	$314	$314	—	—	—	$314 – $314
2	Bcbs Tx mm fee schedule · outpatient	$314	$314	—	—	—	$314 – $314
3	Humana gold choice mm fee schedule · outpatient	$314	$314	—	—	—	$314 – $314
4	Molina medicare adv mm fee schedule · outpatient	$314	$314	—	—	—	$314 – $314
5	UnitedHealthcare mm fee schedule · outpatient	$314	$314	—	—	—	$314 – $314
6	WellCare mm fee schedule · outpatient	$314	$314	—	—	—	$314 – $314
7	Devoted mm fee schedule · outpatient	$339	$339	—	—	—	$339 – $339
8	Humana choicecare fee schedule · outpatient	$455	$455	—	—	—	$455 – $455
9	Bcbs Tx blue advantage hmo fee schedule · outpatient	$712	$712	—	—	—	$712 – $712
10	Bcbs Tx heb fee schedule · outpatient	$783	$783	—	—	—	$783 – $783
11	Bcbs Tx hmo fee schedule · outpatient	$783	$783	—	—	—	$783 – $783
12	Bcbs Tx ppo fee schedule · outpatient	$896	$896	—	—	—	$896 – $896
13	Bcbs Tx traditional fee schedule · outpatient	$924	$924	—	—	—	$924 – $924

Last updated: Jan 13, 2026

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