CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: HCA Houston Healthcare Southeast

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $267
  • Cash Discount Price: $1,318
  • vs. Medicare Baseline: 1.97x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at HCA Houston Healthcare Southeast is $267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,318. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.97x the Medicare baseline. Located in 4000 Spencer Hwy, Pasadena, TX.
Cash / Self-Pay
$1,318

Average discount available for prompt cash payment at this facility.

Insurance Median
$267

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $1,318 (972%)
Insurance Median: $267 (197%)
Cash: $1,318 (972% of Medicare)
Ins. Median: $267 (197% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.6 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 $16 - $97 12%
Community Health Choice Mcd $27 - $211 20%
Amerigroup $29 - $227 21%
Texas Childrens Health Plans $37 - $385 27%
United $42 - $731 31%
Texas Workforce Commission $50 - $390 37%
Healthcare Highways $53 - $414 39%
Molina Healthcare $56 - $438 41%
Evry Health $57 - $443 42%
Chc Harris Health $63 - $487 46%
Aetna $67 - $703 49%
Blue Cross Blue Shield $73 - $568 54%
Imagine Health $73 - $568 54%
Christus (Usfhp) $84 - $649 62%
Curative Administrators $84 - $649 62%
Healthsmart Preferred Care $90 - $1,380 66%
Averde Health $94 - $731 69%
Fidelis Securecare Of Tx $94 - $731 69%
Multiplan $105 - $1,461 77%
Coventry National First Health $111 - $865 82%
Physicians Cooperative Of Texas $115 - $893 85%
Rockport Workers Comp $115 - $893 85%
Beech Street $125 - $1,299 92%
Independent Medical System $125 - $974 92%
National Healthcare Solutions $125 - $974 92%
Prime Health Services $125 - $974 92%
Southwest Medical $125 - $974 92%
Coastal Comp $136 - $1,055 100%
Fiesta Mart, Inc $157 - $1,218 116%
Cigna $167 - $1,299 123%
Physicians, Inc $178 - $1,380 131%
Affiliated Ppo $188 - $1,461 139%
Humana $270 199%
Texas Athletic Network $300 - $600 221%

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