Pegulicianine injection, per milligram 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

Injection, pegulicianine, 1 mg

Jasper, TX

See all hospitals reporting HCPCS A9615 →

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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 $39 is 3% below the median hospital's median price ($40), higher than 41% of the 932 hospitals reporting HCPCS A9615. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9615 at Southeast Texas - Jasper Memorial

Negotiated rates from the hospital’s own file: 7 payers, 14 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	$38	$38	—	—	—	$38 – $38
2	UnitedHealthcare hix fee schedule · outpatient	$38	$38	—	—	—	$38 – $38
3	Aetna mm fee schedule · outpatient	$38	$38	—	—	—	$38 – $38
4	Bcbs Tx mm fee schedule · outpatient	$38	$38	—	—	—	$38 – $38
5	Humana gold choice mm fee schedule · outpatient	$38	$38	—	—	—	$38 – $38
6	Molina medicare adv mm fee schedule · outpatient	$38	$38	—	—	—	$38 – $38
7	UnitedHealthcare mm fee schedule · outpatient	$38	$38	—	—	—	$38 – $38
8	WellCare mm fee schedule · outpatient	$38	$38	—	—	—	$38 – $38
9	Devoted mm fee schedule · outpatient	$41	$41	—	—	—	$41 – $41
10	Bcbs Tx blue advantage hmo fee schedule · outpatient	$157	$157	—	—	—	$157 – $157
11	Bcbs Tx heb fee schedule · outpatient	$173	$173	—	—	—	$173 – $173
12	Bcbs Tx hmo fee schedule · outpatient	$173	$173	—	—	—	$173 – $173
13	Bcbs Tx ppo fee schedule · outpatient	$198	$198	—	—	—	$198 – $198
14	Bcbs Tx traditional fee schedule · outpatient	$204	$204	—	—	—	$204 – $204

Last updated: Jan 13, 2026

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