CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Northside Hospital Forsyth

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $1,141
  • Cash Discount Price: $3,515
  • vs. Medicare Baseline: 6.37x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Northside Hospital Forsyth is $1,141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,515. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 6.37x the Medicare baseline. Located in 1200 Northside Forsyth Drive, Cumming, GA.
Cash / Self-Pay
$3,515

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,141

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$179.2

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $179.2 (100%)
Cash / Self-Pay: $3,515 (1961%)
Insurance Median: $1,141 (637%)
Cash: $3,515 (1961% of Medicare)
Ins. Median: $1,141 (637% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $179.2 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 637% of the Medicare baseline (a markup of 537%). 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
Champus Va $95 53%
Blue Cross Blue Shield $175 - $3,267 98%
Clear Springs Eon Health $175 98%
Medicare (plans) $175 - $214 98%
UnitedHealthcare $175 - $1,307 98%
Va Ccn $175 98%
Humana $177 - $182 99%
Bccp $178 99%
Cbww $178 99%
Tricare $178 99%
Aetna $179 - $1,455 100%
Coventry $179 - $3,187 100%
Caresource $181 - $1,744 101%
Kaiser $181 - $1,483 101%
Wellcare $181 101%
Clover Health $184 103%
Pruitt Health Premier $184 103%
Us Dept Of Labor Wc $223 124%
Mti $235 131%
Fairly Group $237 132%
One Call Diagnostics $242 135%
Homelink $250 140%
Streamline Imaging $260 145%
Genex/Priority Care Solutions $373 208%
Spreemo $373 208%
Truths Community $379 211%
Authentic 4D $420 234%
Direct Pay Provider Network Llc $420 234%
Corvel Workers Comp $443 247%
Employers Choice Network $443 247%
Health One Alliance_Ppo $450 251%
Fieldale Farms Wc $466 260%
Georgia Workers Compensation $466 260%
Med Care Solutions $485 271%
Medlien Healthcare Services $485 271%
Ambetter / Centene $565 - $872 315%
Amerigroup $565 - $667 315%
Medicaid / KanCare $565 - $649 315%
Cigna $673 - $1,387 376%
Oscar $695 388%
Good Samaritan Radiology $937 523%
Northside Health Network $1,448 808%
Georgia Reproductive Specialists $1,875 1046%
Quick Trip $2,578 1439%
Novanet_Ppo $3,281 1831%
Phcs $3,515 1961%
Beech Steet $3,984 2223%
Multiplan $3,984 2223%
Multiplan Workers Comp $3,984 2223%
Careiq $4,687 2616%
Dekalb_Department Of Health $4,687 2616%
Fifa $4,687 2616%
Institutional Marietta Surgery Center $4,687 2616%
Institutional Veterans Evaluation Services $4,687 2616%
Rabun County Boc $4,687 2616%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Northside Forsyth Drive, Cumming, GA 30041
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals