CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: North Austin Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $260
  • Cash Discount Price: $695
  • vs. Medicare Baseline: 2.43x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at North Austin Medical Center is $260. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $695. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.43x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$695

Average discount available for prompt cash payment at this facility.

Insurance Median
$260

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $695 (651%)
Insurance Median: $260 (243%)
Cash: $695 (651% of Medicare)
Ins. Median: $260 (243% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 243% of the Medicare baseline (a markup of 143%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $16 - $199 15%
Amerigroup $65 61%
Moda $76 - $274 71%
United $80 - $526 75%
Covenant Management Systems $93 - $336 87%
Healthcare Highways $94 - $350 88%
Blue Cross Blue Shield $95 - $345 89%
Imo Med - Select Network $97 - $350 91%
Nomi Health $103 - $432 96%
St David’S Hospice $105 98%
Molina Healthcare $115 108%
Moda Health $116 - $432 109%
Evry Health $119 - $430 111%
Texas Healthcare Foundation Heb $120 - $432 112%
Texas Workforce Commission $126 - $456 118%
Curative Administrators $129 - $467 121%
Harbor Health Team $129 - $467 121%
Humana $131 123%
Sendero $131 123%
Aetna $132 - $817 124%
Averde Health $145 - $526 136%
UnitedHealthcare $145 - $526 136%
Comanche County $162 - $584 152%
National Choicecare $162 - $584 152%
Healthsmart Preferred Care $178 - $934 167%
Independent Medical Systems $178 - $642 167%
Physicians Cooperative Of Texas $178 - $642 167%
Prime Health $194 - $701 182%
First Health $202 - $829 189%
Coastal Comp Health Networks $210 - $759 197%
National Health Care $210 - $759 197%
Texas Municipal League $226 - $818 212%
Medcorp Southwest $242 - $876 227%
Rockport Healthcare Group $258 - $1,051 242%
Bce Emergis Corporation $291 - $1,051 272%
Beech Street $291 - $1,051 272%
Medical Control Network Solutions $291 - $1,051 272%
Multiplan $291 - $1,051 272%

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