CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Northside Hospital Forsyth

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $331
  • Cash Discount Price: $407
  • vs. Medicare Baseline: 5.49x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Northside Hospital Forsyth is $331. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $407. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 5.49x the Medicare baseline. Located in 1200 Northside Forsyth Drive, Cumming, GA.
Cash / Self-Pay
$407

Average discount available for prompt cash payment at this facility.

Insurance Median
$331

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$60.27

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $60.27 (100%)
Cash / Self-Pay: $407 (675%)
Insurance Median: $331 (549%)
Cash: $407 (675% of Medicare)
Ins. Median: $331 (549% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $60.27 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 549% of the Medicare baseline (a markup of 449%). 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 $6 10%
Mti $10 17%
One Call Diagnostics $10 17%
Homelink $11 18%
Blue Cross Blue Shield $59 - $378 98%
Clear Springs Eon Health $59 98%
Medicare (plans) $59 - $72 98%
UnitedHealthcare $59 - $383 98%
Va Ccn $59 98%
Aetna $60 - $369 100%
Bccp $60 100%
Cbww $60 100%
Coventry $60 - $369 100%
Humana $60 - $61 100%
Tricare $60 100%
Caresource $61 - $202 101%
Kaiser $61 - $472 101%
Wellcare $61 101%
Clover Health $62 103%
Pruitt Health Premier $62 103%
Ambetter / Centene $65 - $255 108%
Amerigroup $65 - $77 108%
Medicaid / KanCare $65 - $75 108%
Fairly Group $68 113%
Lantern $73 121%
Us Dept Of Labor Wc $75 124%
Cigna $78 - $341 129%
Truths Community $116 192%
Genex/Priority Care Solutions $124 206%
Spreemo $124 206%
Authentic 4D $140 232%
Streamline Imaging $140 232%
Corvel Workers Comp $148 246%
Employers Choice Network $148 246%
Fieldale Farms Wc $156 259%
Georgia Workers Compensation $156 259%
Georgia Reproductive Specialists $217 360%
Medlien Healthcare Services $217 360%
Med Care Solutions $244 405%
Oscar $255 423%
Health One Alliance_Ppo $298 494%
Quick Trip $298 494%
Northside Health Network $336 557%
Novanet_Ppo $379 629%
Phcs $406 674%
Beech Steet $461 765%
Multiplan $461 765%
Multiplan Workers Comp $461 765%
Careiq $542 899%
Dekalb_Department Of Health $542 899%
Fifa $542 899%
Institutional Marietta Surgery Center $542 899%
Institutional Veterans Evaluation Services $542 899%
Rabun County Boc $542 899%

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