Houston Methodist Clear Lake Hospital
18300 St John Drive, Nassau Bay, TX 77058 · 127 Priced Procedures · 85% Patient Recommendation
Typical commercial prices here are +20% above the fair benchmark (1.20×) even after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 1.20× fair market pricing.
Aligned Regional Benchmark Peer
Houston Methodist Clear Lake Hospital prices shoppable and inpatient services (1.3× to 1.5× Medicare, divergence 1.15×) in alignment with regional hospital peers (1.20× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.97× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 10% of shoppable procedures (99/100 Cash Honesty)
- 5-Star CMS clinical rating with 85% patient recommendation (77/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (8.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.6× markup over Medicare rates
- Captive ER (1.9×) & laboratory (0.9×) services average 1.15× higher multiples than routine shoppable care (1.3×)
- Upper-quartile procedures (Q75 1.56×) jump +41% above the median procedure ratio (Q50 1.11×)
- Unnegotiated chargemaster list prices average 16.1× Medicare (14¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Houston Methodist Clear Lake Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 127 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $27,639 | 0.9× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $18,116 | 0.9× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $17,300 | 0.9× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $15,859 | 0.9× |
| Total hip replacement CPT Code: 27130 | $13,898 | 1.0× |
| Total knee replacement CPT Code: 27447 | $13,898 | 1.0× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $7,964 | 1.0× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $7,391 | 1.2× |
| C-section delivery (full package) CPT Code: 59510 | $6,543 | 2.2× |
| Vaginal delivery (full package) CPT Code: 59400 | $6,261 | 2.3× |
| Cataract surgery with lens implant CPT Code: 66984 | $4,521 | unverified |
| Breast lump removal CPT Code: 19120 | $4,130 | 1.1× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $4,055 | 1.2× |
| Inguinal hernia repair CPT Code: 49505 | $4,055 | 1.1× |
| Bunion correction surgery CPT Code: 28296 | $3,616 | 1.0× |
| Trauma team activation HCPCS Code: G0390 | $1,453 | 1.0× |
| Injection procedure for pain management HCPCS Code: G0260 | $1,329 | 1.6× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $914 | 0.9× |
| Colonoscopy with biopsy CPT Code: 45380 | $896 | unverified |
| Colonoscopy (diagnostic) CPT Code: 45378 | $866 | unverified |
| Blood transfusion CPT Code: 36430 | $722 | 1.4× |
| Group therapy session CPT Code: 90853 | $594 | 5.9× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $571 | 1.0× |
| Upper endoscopy with biopsy CPT Code: 43239 | $592 | unverified |
| Psychological testing by technician CPT Code: 96138 | $467 | 1.2× |
Audit a Bill or Quote at Houston Methodist Clear Lake Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $5,300
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (8.0% of gross = $5,300).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Houston Methodist Clear Lake Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($66,334) is $35,559 above the denoised Fair BaseRate ($30,775) and 2.8× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (8.0% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (1,165 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Houston Methodist Clear Lake Hospital.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.