CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: St Luke's Sugar Land Hospital

Billing Code: 99214 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$232

about 1.7× the $136 Medicare rate · typically $106–$321

modeled estimate · not a bill or quote

What this hospital charges insurers

$313

Above the fair price

about $81 over the fair price · 2.3× Medicare

Medicare pays $136 Fair price $232 This hospital $313 Cash price $169 Hospital's list price $482

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 $48 Priciest $313

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

A fair price for a Office visit, established patient (30-39 min) is about $232 (about 1.7× the $136 Medicare rate). St Luke's Sugar Land Hospital charges insurers about $313, or about $169 in cash — above the fair price. Located in Sugar Land, TX.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $232. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$74 - $398	55%
Blue Cross Blue Shieldmajor	$117 - $254	86%
Aetnamajor	$313	231%
Cignamajor	$289 - $337	213%
Humanamajor	$313	231%
Health Net	$410 - $482	302%
+ 3 smaller / regional plans	$169 - $337

Excludes 3 rental-network / third-party entries (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 169), 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: 99214.

Insurance Before you use insurance

Call your insurance company to confirm St Luke's Sugar Land Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 99214.
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 St Luke's Sugar Land Hospital

Compare: Office visit, established patient (30-39 min) at other TX hospitals

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