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.
Original text from hospital filings
PRE-PLAN 3D MODEL W/CCTA
Jasper, TX
See all hospitals reporting HCPCS C9793 →Price type
Southeast Texas - Jasper Memorial’s median price of $1.1k is about the same as the median hospital's median price ($1.1k), higher than 50% of the 956 hospitals reporting HCPCS C9793. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
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 hix fee schedule · outpatient | $91 | $91 | — | — | — | $91 – $91 |
| 2 | UnitedHealthcare all payer fee schedule · outpatient | $261 | $261 | — | — | — | $261 – $261 |
| 3 | Aetna mm fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 4 | Bcbs Tx mm fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 5 | Humana gold choice mm fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 6 | Molina medicare adv mm fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 7 | UnitedHealthcare mm fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 8 | WellCare mm fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 9 | Devoted mm fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 10 | Bcbs Tx blue advantage hmo fee schedule · outpatient | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
| 11 | Bcbs Tx heb fee schedule · outpatient | $4.8k | $4.8k | — | — | — | $4.8k – $4.8k |
| 12 | Bcbs Tx hmo fee schedule · outpatient | $4.8k | $4.8k | — | — | — | $4.8k – $4.8k |
| 13 | Bcbs Tx ppo fee schedule · outpatient | $5.5k | $5.5k | — | — | — | $5.5k – $5.5k |
| 14 | Bcbs Tx traditional fee schedule · outpatient | $5.7k | $5.7k | — | — | — | $5.7k – $5.7k |
Last updated: Jan 13, 2026
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