CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: North Austin Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $197
  • Cash Discount Price: $315
  • vs. Medicare Baseline: 1.68x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at North Austin Medical Center is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $315. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.68x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$315

Average discount available for prompt cash payment at this facility.

Insurance Median
$197

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $315 (268%)
Insurance Median: $197 (168%)
Cash: $315 (268% of Medicare)
Ins. Median: $197 (168% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

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

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Superior Health Plan $13 - $348 11%
Amerigroup $47 40%
Imperial Insurance $50 - $390 43%
Moda $62 - $482 53%
United $65 - $922 55%
Covenant Management Systems $76 - $590 65%
Healthcare Highways $77 - $615 65%
Blue Cross Blue Shield $78 - $605 66%
Imo Med - Select Network $79 - $615 67%
Nomi Health $84 - $758 71%
Shared Health $92 - $718 78%
Aetna $94 - $1,146 80%
Moda Health $95 - $758 81%
Evry Health $97 - $754 83%
Texas Healthcare Foundation Heb $97 - $758 83%
Texas Workforce Commission $103 - $800 88%
Curative Administrators $105 - $820 89%
Harbor Health Team $105 - $820 89%
Averde Health $118 - $922 100%
Naphcare $118 - $922 100%
Seven Corners $118 - $922 100%
UnitedHealthcare $118 - $922 100%
Austin Fc $132 - $1,025 112%
Comanche County $132 - $1,025 112%
National Choicecare $132 - $1,025 112%
Healthsmart Preferred Care $145 - $1,640 123%
Independent Medical Systems $145 - $1,128 123%
Physicians Cooperative Of Texas $145 - $1,128 123%
Prime Health $158 - $1,230 134%
First Health $164 - $1,456 139%
Coastal Comp Health Networks $171 - $1,332 145%
National Health Care $171 - $1,332 145%
Texas Municipal League $184 - $1,435 157%
Medcorp Southwest $197 - $1,538 168%
Rockport Healthcare Group $210 - $1,845 179%
Bce Emergis Corporation $237 - $1,845 202%
Beech Street $237 - $1,845 202%
Medical Control Network Solutions $237 - $1,845 202%
Multiplan $237 - $1,845 202%
Oscar $394 - $439 335%
Cigna $658 - $840 560%

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