HealthSmart ER Visit Rates in Houston

Published HealthSmart negotiated rates for ER Visit at 14 hospitals in Houston, TX. Data from CMS-mandated hospital transparency files.

Lowest Rate

$851.2

HCA Houston Healthcare Kingwood

all plan types

Highest Rate

$3,520.3

St Luke's The Woodlands

all plan types

Rate Spread

4x

across all plan types

Hospitals

14

with HealthSmart data

HealthSmart er-visit rates in Houston vary dramatically, with a 4x spread from $851 at HCA Kingwood to $3,520 at St Luke's The Woodlands. The median rate across 14 hospitals is $2,821, though lowest rates often reflect Medicaid or Medicare contracts rather than commercial plans.

Why the range is so wide: HealthSmart negotiates different rates for different plan types. Medicaid-managed and Medicare Advantage plans typically have the lowest negotiated rates. Commercial PPO and HMO plans are higher. The "lowest rate" at each hospital may be a Medicaid or Medicare plan rate, not a commercial plan rate. The plan type is shown in the table where available.

HealthSmart ER Visit Rates by Hospital

Hospital Lowest HealthSmart Rate
HCA Houston Healthcare Kingwood $851.2
HCA Houston Healthcare Conroe $938
HCA Houston Healthcare Southeast $1,163.49
HCA Houston Healthcare Clear Lake $1,191.94
HCA Houston Healthcare Mainland $1,191.94
HCA Houston Healthcare West $1,296.45
Texas Children's Hospital $1,422.4
St Luke's Patients Medical Center $1,783.6
Baylor St Luke's Medical Center $1,924.3
St Luke's Lakeside $1,924.3
St Luke's Springwoods Village $1,924.3
St Luke's Sugar Land $1,924.3
St Luke's The Vintage $1,924.3
St Luke's The Woodlands $1,924.3

Rates shown are HealthSmart's published negotiated rates from each hospital's CMS transparency file. "Lowest rate" is the lowest rate across all HealthSmart plan types (including Medicaid-managed and Medicare Advantage) at that hospital. Commercial plan rates are typically higher. Your actual cost depends on your specific plan's deductible, copay, and coinsurance.

Understanding HealthSmart Negotiated Rates

A negotiated rate is the price HealthSmart has agreed to pay a hospital for a specific service. This is not necessarily what you pay out of pocket. If you have met your annual deductible, you typically pay a copay or coinsurance percentage of the negotiated rate. If you have not met your deductible, you may owe the full negotiated rate.

The same insurer often negotiates different rates at different hospitals, and different plan types (HMO, PPO, high-deductible) within the same insurer can have different rates at the same hospital. The table above shows the range across all HealthSmart plan types at each facility.

Prices shown are facility fees only. You will also receive separate bills from the physician performing the procedure.

Compare Other Insurers for ER Visit in Houston

View all ER Visit prices in Houston (cash + insured) →

Frequently Asked Questions

Where is the lowest-cost HealthSmart ER Visit in Houston?

The lowest HealthSmart negotiated rate for ER Visit in Houston is $851.2 at HCA Houston Healthcare Kingwood, across all plan types including Medicaid-managed and Medicare Advantage. The highest is $3,520.3 at St Luke's The Woodlands, a 4x difference. Commercial plan rates typically fall between these extremes.

Is the HealthSmart negotiated rate what I'll pay?

Not necessarily. The negotiated rate is what HealthSmart has agreed to pay the hospital. Your out-of-pocket cost depends on your deductible, copay, and coinsurance. If you have not met your annual deductible, you may owe the full negotiated rate. Contact HealthSmart for a pre-service cost estimate specific to your plan.

How many Houston hospitals have published HealthSmart rates?

14 hospitals in the Houston area have published HealthSmart negotiated rates for ER Visit in their CMS transparency files. Having a published rate does not necessarily confirm current network participation. Verify your network status with HealthSmart directly.

Will HealthSmart cover an out-of-network ER visit?

Under the No Surprises Act, emergency services must be covered regardless of network status. HealthSmart cannot charge you more than your in-network cost-sharing for emergency care, even at an out-of-network hospital. This applies to the ER visit itself, though follow-up care after you are stabilized may be billed differently.

We are not affiliated with HealthSmart or any hospital listed on this page. Negotiated rates are sourced from hospital-published CMS transparency files and represent the amounts agreed between the insurer and hospital. Your actual out-of-pocket cost depends on your deductible, copay, and coinsurance. Contact HealthSmart or the hospital billing department for a cost estimate specific to your plan. All insurer and hospital names are trademarks of their respective owners.

Visit the official HealthSmart website: www.healthsmart.com