CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: North Austin Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,362
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at North Austin Medical Center is $8,362. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.47x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,362

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5,675.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5,675.87 (100%)
Insurance Median: $8,362 (147%)
Ins. Median: $8,362 (147% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5,675.87 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $991 - $14,113 17%
American Health Plan Of Texas $1,275 - $9,018 22%
Oscar $1,633 - $10,000 29%
First Health $2,308 41%
United $3,085 - $9,660 54%
Aetna $3,463 - $8,772 61%
Evry Health $4,052 - $15,935 71%
Cigna $4,649 - $8,362 82%
Moda $5,813 102%
Altus Hospice (Hospice Of The Hills) $7,378 130%
Cella Bella Hospice $7,378 130%
Compassionate Care Mcr $7,378 130%
Heart To Heart Hospice $7,378 130%
Hospice Austin $7,378 130%
Hospice Compassus $7,378 130%
Silverado Hospice $7,378 130%
St David’S Hospice $7,378 130%
Wellmed $8,092 143%
Angel Heart Hospice $8,198 144%
Aseracare Hospice $8,198 144%
Girling Hospice $8,198 144%
Lighthouse Hospice, Llc. $8,198 144%
Odyssey Hospice $8,198 144%
Southern Care Hospice $8,198 144%
Texas Home Health Hospice $8,198 144%
Triwest Healthcare Alliance $8,198 144%
UnitedHealthcare $8,198 144%
Vistacare Family Hospice $8,198 144%
Wesleyan Homes, Inc. $8,198 144%
Devoted Health $8,362 147%
Provider Partners Health Plan $8,362 147%
Superior Health Plan $8,608 - $13,117 152%
Universal Health $8,608 152%
Imperial Insurance $8,690 153%
Humana $8,772 155%
Shared Health $8,772 155%
Molina Healthcare $8,936 157%
Pyramid Life $9,018 159%
Texas Independent Health Plan $9,100 160%
Wellcare $9,100 160%
Nomi Health $9,202 - $9,687 162%
Healthcare Highways $9,789 - $9,987 172%
Austin Fc $10,248 181%
Harbor Health Team $10,271 181%
Moda Health $10,552 - $10,763 186%
Curative Administrators $10,640 187%
Sendero $11,067 - $14,019 195%
Corvel Corporation $11,606 204%
Naphcare $12,707 224%
Seven Corners $12,707 224%
Covenant Management Systems $12,890 227%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals