CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: HCA Houston Healthcare Tomball

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$167

about 1.8× the $95 Medicare rate · typically $71–$199

modeled estimate · not a bill or quote

What this hospital charges insurers

$171

About the fair price

about $4 over the fair price · 1.8× Medicare

Medicare pays $95 Fair price $167 This hospital $171 Cash price $1,831 Hospital's list price $1,831

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $34 Priciest $171

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Office visit, established patient (20-29 min) is about $167 (about 1.8× the $95 Medicare rate). HCA Houston Healthcare Tomball charges insurers about $171, or about $1,831 in cash — about the fair price. Located in Tomball, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$180 - $1,166	189%
Blue Cross Blue Shieldmajor	$121 - $907	127%
Aetnamajor	$71 - $954	75%
Humanamajor	$201	211%
Healthcare Highways	$273 - $661	287%
Molina	$289 - $700	304%
+ 5 smaller / regional plans	$139 - $1,037

Government programs also on file: Medicaid.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,831), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99213.

Insurance Before you use insurance

Call your insurance company to confirm HCA Houston Healthcare Tomball is in-network.
Ask your insurer whether prior approval is required for CPT code 99213.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at HCA Houston Healthcare Tomball

Compare: Office visit, established patient (20-29 min) at other TX hospitals

Insurance negotiated median for the same procedure, sorted lowest first.