Thiamine hydrochloride injection, 100 mg/mL 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

sodium chloride 0.9 % 1,000 mL with multivitamin adult 10 mL, thiamine 100 mg, folic acid 1 mg IVPB

Jasper, TX

See all hospitals reporting HCPCS J3411 →

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How this price compares nationally

Southeast Texas - Jasper Memorial’s median price of $30 is 156% above the median hospital's median price ($12), higher than 78% of the 2,301 hospitals reporting HCPCS J3411. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J3411 at Southeast Texas - Jasper Memorial

Negotiated rates from the hospital’s own file: 11 payers, 28 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	$2	$2	—	—	—	$2 – $2
2	UnitedHealthcare hix fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
3	Aetna new business fee schedule · outpatient	$3	$3	—	—	—	$3 – $3
4	Aetna epo fee schedule · outpatient	$4	$4	—	—	—	$4 – $4
5	Aetna hmo fee schedule · outpatient	$4	$4	—	—	—	$4 – $4
6	Aetna pos fee schedule · outpatient	$4	$4	—	—	—	$4 – $4
7	Aetna ppo fee schedule · outpatient	$4	$4	—	—	—	$4 – $4
8	Humana choicecare fee schedule · outpatient	$7	$7	—	—	—	$7 – $7
9	Bcbs Tx blue advantage hmo fee schedule · outpatient	$14	$14	—	—	—	$14 – $14
10	UnitedHealthcare chip km percent of total billed charges · outpatientfrom % of charges	$17	$14	$5	39%	—	$6 – $17
11	UnitedHealthcare star kid km percent of total billed charges · outpatientfrom % of charges	$17	$14	$5	39%	—	$6 – $17
12	UnitedHealthcare star km percent of total billed charges · outpatientfrom % of charges	$17	$14	$5	39%	—	$6 – $17
13	UnitedHealthcare star plus km percent of total billed charges · outpatientfrom % of charges	$17	$14	$5	39%	—	$6 – $17
14	Bcbs Tx heb fee schedule · outpatient	$15	$15	—	—	—	$15 – $15
15	Bcbs Tx hmo fee schedule · outpatient	$15	$15	—	—	—	$15 – $15
16	Bcbs Tx ppo fee schedule · outpatient	$17	$17	—	—	—	$17 – $17
17	Bcbs Tx traditional fee schedule · outpatient	$18	$18	—	—	—	$18 – $18
18	Aetna mm percent of total billed charges · outpatientfrom % of charges	$30	$23	$9	39%	—	$10 – $30
19	Molina chip km percent of total billed charges · outpatientfrom % of charges	$37	$29	$11	39%	—	$13 – $37
20	Molina star km percent of total billed charges · outpatientfrom % of charges	$37	$29	$11	39%	—	$13 – $37
21	Molina star plus km percent of total billed charges · outpatientfrom % of charges	$37	$29	$11	39%	—	$13 – $37
22	Cigna new business percent of total billed charges · outpatientfrom % of charges	$49	$38	$15	39%	—	$17 – $49
23	Healthcare Highways ppo percent of total billed charges · outpatientfrom % of charges	$56	$44	$17	39%	—	$20 – $56
24	Devoted mm percent of total billed charges · outpatientfrom % of charges	$62	$49	$19	39%	—	$22 – $62
25	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$75	$58	$23	39%	—	$26 – $75

Page 1 of 2 · 28 rates

Last updated: Jan 13, 2026

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