Unlike say, a printed page, the absolute look of a web page is not necessarily fixed. That's because the language of the web is a set of instructions that tell the browser on the client device (computer, smart phone, tablet etc.) what to display and how to display it. The exact look is determined by how the browser interprets those instructions, including the screen size or the size of the browser on the screen. For that reason alone, it is important that the format of those instructions, which comprise a mixture of HTML and CSS, meet the international standards laid down by the standards organisation – the World Wide Web Consortium (W3C).
There are a number of web design tools that allow designers to create WYSIWYG page designs, as you might when creating Word type documents, and generate the appropriate HTML and CSS. However, since all of the above languages are scripting languages, they can be written using a simple text editor and, in order to maintain strict compliance with the HTML and CSS standards, which itself maximises the probability that each page "works" on the plethora of browsers and devices that are in use, I prefer to use such an editor, albeit one that is designed for the purpose to minimise errors in the markup.
My designs are therefore "handcrafted" where each part of the design is hand written. This sounds like a long winded way of doing things but actually I can quickly copy and paste snippets of markup and code that I have developed over many years, combine these with newer techniques and methods, and incorporate them into the finished article. This is actually quite a quick way to create a working, standards compliant, website.
I constantly keep abreast of developments and would make valued judgements about the techniques that are best for your site and your requirements, just as I have done for a decade and more.
The latest variation of HTML and CSS standards are HTML5 and CSS3. HTML5 and CSS3 are your friends! Now that all modern browsers support the most important parts of HTML5 and CSS3, building web pages with good looking features is now possible with minimal effort. Visual features such as shadows and rounded corners that could previously only be achieved by fastening together carefully crafted graphics can now be achieved by simple instructions to the browser, thus speeding up development time and therefore making the whole process cheaper. My latest designs are now built in HTML5 and can make use of those CSS3 features that are widely supported.
My preferred server side programming language is PHP which means "PHP: Hypertext Preprocessor" - I know, it doesn't make sense but it's apparently a "recursive backronym" that originally stood for "Personal Home Page". This is readily available on most hosting packages and is generally cheaper than the alternatives.
In cases where a back-end database is required, for example where the site includes a content management system, then MySQL is my favourite. Again, this is readily available on most hosting packages and is generally cheaper than the alternatives.
As already mentioned, I make a point of designing and building websites that meet World Wide Web Consortium (W3C) standards. These are not only HTML and CSS but where possible and sensible my design and build will comply with the Web Content Accessibility Guidelines (WCAG).