5% dextrose in lactated Ringer's solution 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

dextrose 5 % in lactated ringers infusion

Jasper, TX

See all hospitals reporting HCPCS J7121 →

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How this price compares nationally

Southeast Texas - Jasper Memorial’s median price of $44 is 143% above the median hospital's median price ($18), higher than 75% of the 1,796 hospitals reporting HCPCS J7121. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J7121 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	Humana choicecare fee schedule · outpatient	$3	$3	—	—	—	$3 – $3
2	UnitedHealthcare all payer fee schedule · outpatient	$6	$6	—	—	—	$6 – $6
3	UnitedHealthcare hix fee schedule · outpatient	$6	$6	—	—	—	$6 – $6
4	UnitedHealthcare chip km percent of total billed charges · outpatientfrom % of charges	$21	$21	—	—	—	$21 – $21
5	UnitedHealthcare star kid km percent of total billed charges · outpatientfrom % of charges	$21	$21	—	—	—	$21 – $21
6	UnitedHealthcare star km percent of total billed charges · outpatientfrom % of charges	$21	$21	—	—	—	$21 – $21
7	UnitedHealthcare star plus km percent of total billed charges · outpatientfrom % of charges	$21	$21	—	—	—	$21 – $21
8	Bcbs Tx blue advantage hmo fee schedule · outpatient	$22	$22	—	—	—	$22 – $22
9	Bcbs Tx heb fee schedule · outpatient	$24	$24	—	—	—	$24 – $24
10	Bcbs Tx hmo fee schedule · outpatient	$24	$24	—	—	—	$24 – $24
11	Bcbs Tx ppo fee schedule · outpatient	$27	$27	—	—	—	$27 – $27
12	Bcbs Tx traditional fee schedule · outpatient	$28	$28	—	—	—	$28 – $28
13	Aetna mm percent of total billed charges · outpatientfrom % of charges	$35	$35	—	—	—	$35 – $35
14	Molina chip km percent of total billed charges · outpatientfrom % of charges	$44	$44	—	—	—	$44 – $44
15	Molina star km percent of total billed charges · outpatientfrom % of charges	$44	$44	—	—	—	$44 – $44
16	Molina star plus km percent of total billed charges · outpatientfrom % of charges	$44	$44	—	—	—	$44 – $44
17	Cigna new business percent of total billed charges · outpatientfrom % of charges	$57	$57	—	—	—	$57 – $57
18	Healthcare Highways ppo percent of total billed charges · outpatientfrom % of charges	$66	$66	—	—	—	$66 – $66
19	Devoted mm percent of total billed charges · outpatientfrom % of charges	$73	$73	—	—	—	$73 – $73
20	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$88	$88	—	—	—	$88 – $88
21	Aetna new business percent of total billed charges · outpatientfrom % of charges	$91	$91	—	—	—	$91 – $91
22	First Health ppo percent of total billed charges · outpatientfrom % of charges	$95	$95	—	—	—	$95 – $95
23	Aetna epo percent of total billed charges · outpatientfrom % of charges	$101	$101	—	—	—	$101 – $101
24	Aetna hmo percent of total billed charges · outpatientfrom % of charges	$101	$101	—	—	—	$101 – $101
25	Aetna pos percent of total billed charges · outpatientfrom % of charges	$101	$101	—	—	—	$101 – $101

Page 1 of 2 · 28 rates

Last updated: Jan 13, 2026

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