Low-osmolar contrast dye, 1 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

iopamidol (ISOVUE-M 200) 41 % injection

Jasper, TX

See all hospitals reporting HCPCS Q9966 →

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How this price compares nationally

Southeast Texas - Jasper Memorial’s median price of $129 is 2538% above the median hospital's median price ($5), higher than 84% of the 2,032 hospitals reporting HCPCS Q9966. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q9966 at Southeast Texas - Jasper Memorial

Negotiated rates from the hospital’s own file: 11 payers, 23 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	$0	$0	—	—	—	$0 – $0
2	UnitedHealthcare hix fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
3	Humana choicecare fee schedule · outpatient	$1	$1	—	—	—	$1 – $1
4	Bcbs Tx blue advantage hmo fee schedule · outpatient	$1	$1	—	—	—	$1 – $1
5	Bcbs Tx heb fee schedule · outpatient	$1	$1	—	—	—	$1 – $1
6	Bcbs Tx hmo fee schedule · outpatient	$1	$1	—	—	—	$1 – $1
7	Bcbs Tx ppo fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
8	Bcbs Tx traditional fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
9	UnitedHealthcare chip km percent of total billed charges · outpatientfrom % of charges	$60	$60	—	—	—	$60 – $60
10	UnitedHealthcare star kid km percent of total billed charges · outpatientfrom % of charges	$60	$60	—	—	—	$60 – $60
11	UnitedHealthcare star km percent of total billed charges · outpatientfrom % of charges	$60	$60	—	—	—	$60 – $60
12	UnitedHealthcare star plus km percent of total billed charges · outpatientfrom % of charges	$60	$60	—	—	—	$60 – $60
13	Aetna mm percent of total billed charges · outpatientfrom % of charges	$103	$103	—	—	—	$103 – $103
14	Molina chip km percent of total billed charges · outpatientfrom % of charges	$129	$129	—	—	—	$129 – $129
15	Molina star km percent of total billed charges · outpatientfrom % of charges	$129	$129	—	—	—	$129 – $129
16	Molina star plus km percent of total billed charges · outpatientfrom % of charges	$129	$129	—	—	—	$129 – $129
17	Cigna new business percent of total billed charges · outpatientfrom % of charges	$168	$168	—	—	—	$168 – $168
18	Healthcare Highways ppo percent of total billed charges · outpatientfrom % of charges	$194	$194	—	—	—	$194 – $194
19	Devoted mm percent of total billed charges · outpatientfrom % of charges	$215	$215	—	—	—	$215 – $215
20	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$258	$258	—	—	—	$258 – $258
21	First Health ppo percent of total billed charges · outpatientfrom % of charges	$280	$280	—	—	—	$280 – $280
22	MultiPlan ppo percent of total billed charges · outpatientfrom % of charges	$280	$280	—	—	—	$280 – $280
23	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$280	$280	—	—	—	$280 – $280

Last updated: Jan 13, 2026

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