CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: HCA Houston Healthcare Southeast

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $196
  • Cash Discount Price: $722
  • vs. Medicare Baseline: 1.67x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at HCA Houston Healthcare Southeast is $196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $722. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.67x the Medicare baseline. Located in 4000 Spencer Hwy, Pasadena, TX.
Cash / Self-Pay
$722

Average discount available for prompt cash payment at this facility.

Insurance Median
$196

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $722 (614%)
Insurance Median: $196 (167%)
Cash: $722 (614% of Medicare)
Ins. Median: $196 (167% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Superior Health Plan $15 - $87 13%
Community Health Choice Mcd $32 - $189 27%
Amerigroup $34 - $204 29%
Texas Childrens Health Plans $43 - $345 37%
United $49 - $655 42%
Texas Workforce Commission $58 - $349 49%
Healthcare Highways $62 - $371 53%
Evry Health $66 - $397 56%
Molina Healthcare $66 - $393 56%
Chc Harris Health $73 - $437 62%
Aetna $78 - $630 66%
Blue Cross Blue Shield $85 - $510 72%
Imagine Health $85 - $510 72%
Christus (Usfhp) $97 - $582 83%
Curative Administrators $97 - $582 83%
Healthsmart Preferred Care $105 - $1,237 89%
Averde Health $110 - $655 94%
Fidelis Securecare Of Tx $110 - $655 94%
Multiplan $122 - $1,310 104%
Coventry National First Health $130 - $776 111%
Physicians Cooperative Of Texas $134 - $801 114%
Rockport Workers Comp $134 - $801 114%
Beech Street $146 - $1,165 124%
Independent Medical System $146 - $873 124%
National Healthcare Solutions $146 - $873 124%
Prime Health Services $146 - $873 124%
Southwest Medical $146 - $873 124%
Coastal Comp $158 - $946 134%
Fiesta Mart, Inc $183 - $1,092 156%
Cigna $195 - $1,165 166%
Physicians, Inc $207 - $1,237 176%
Affiliated Ppo $219 - $1,310 186%
Humana $289 246%
Texas Athletic Network $300 - $600 255%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4000 Spencer Hwy, Pasadena, TX 77504
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals