Hydroxychloroquine 200 mg oral tablet 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

CEPHALEXIN 250 MG/5ML PO SUSR

Jasper, TX

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How this price compares nationally

Southeast Texas - Jasper Memorial’s median price of $8 is 58% below the median hospital's median price ($18), higher than 36% of the 983 hospitals reporting HCPCS J8499. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J8499 at Southeast Texas - Jasper Memorial

Negotiated rates from the hospital’s own file: 10 payers, 25 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 chip km percent of total billed charges · outpatientfrom % of charges	$2	$2	—	—	—	$2 – $2
2	UnitedHealthcare star kid km percent of total billed charges · outpatientfrom % of charges	$2	$2	—	—	—	$2 – $2
3	UnitedHealthcare star km percent of total billed charges · outpatientfrom % of charges	$2	$2	—	—	—	$2 – $2
4	UnitedHealthcare star plus km percent of total billed charges · outpatientfrom % of charges	$2	$2	—	—	—	$2 – $2
5	Aetna mm percent of total billed charges · outpatientfrom % of charges	$4	$4	—	—	—	$4 – $4
6	Molina chip km percent of total billed charges · outpatientfrom % of charges	$5	$5	—	—	—	$5 – $5
7	Molina star km percent of total billed charges · outpatientfrom % of charges	$5	$5	—	—	—	$5 – $5
8	Molina star plus km percent of total billed charges · outpatientfrom % of charges	$5	$5	—	—	—	$5 – $5
9	Cigna new business percent of total billed charges · outpatientfrom % of charges	$6	$6	—	—	—	$6 – $6
10	Healthcare Highways ppo percent of total billed charges · outpatientfrom % of charges	$7	$7	—	—	—	$7 – $7
11	Bcbs Tx blue advantage hmo percent of total billed charges · outpatientfrom % of charges	$7	$7	—	—	—	$7 – $7
12	Devoted mm percent of total billed charges · outpatientfrom % of charges	$8	$8	—	—	—	$8 – $8
13	Bcbs Tx heb percent of total billed charges · outpatientfrom % of charges	$8	$8	—	—	—	$8 – $8
14	Bcbs Tx hmo percent of total billed charges · outpatientfrom % of charges	$8	$8	—	—	—	$8 – $8
15	Bcbs Tx ppo percent of total billed charges · outpatientfrom % of charges	$9	$9	—	—	—	$9 – $9
16	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$10	$10	—	—	—	$10 – $10
17	Bcbs Tx traditional percent of total billed charges · outpatientfrom % of charges	$10	$10	—	—	—	$10 – $10
18	Aetna new business percent of total billed charges · outpatientfrom % of charges	$10	$10	—	—	—	$10 – $10
19	First Health ppo percent of total billed charges · outpatientfrom % of charges	$10	$10	—	—	—	$10 – $10
20	Aetna epo percent of total billed charges · outpatientfrom % of charges	$11	$11	—	—	—	$11 – $11
21	Aetna hmo percent of total billed charges · outpatientfrom % of charges	$11	$11	—	—	—	$11 – $11
22	Aetna pos percent of total billed charges · outpatientfrom % of charges	$11	$11	—	—	—	$11 – $11
23	Aetna ppo percent of total billed charges · outpatientfrom % of charges	$11	$11	—	—	—	$11 – $11
24	MultiPlan ppo percent of total billed charges · outpatientfrom % of charges	$11	$11	—	—	—	$11 – $11
25	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$11	$11	—	—	—	$11 – $11

Last updated: Jan 13, 2026

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