CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Northside Hospital Forsyth

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $1,581
  • Cash Discount Price: $4,665
  • vs. Medicare Baseline: 6.49x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Northside Hospital Forsyth is $1,581. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,665. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.49x the Medicare baseline. Located in 1200 Northside Forsyth Drive, Cumming, GA.
Cash / Self-Pay
$4,665

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,581

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $4,665 (1914%)
Insurance Median: $1,581 (649%)
Cash: $4,665 (1914% of Medicare)
Ins. Median: $1,581 (649% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 649% of the Medicare baseline (a markup of 549%). 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 $126 52%
Blue Cross Blue Shield $238 - $4,335 98%
Clear Springs Eon Health $238 98%
Medicare (plans) $238 - $291 98%
UnitedHealthcare $238 - $2,367 98%
Va Ccn $238 98%
Humana $241 - $248 99%
Bccp $242 99%
Cbww $242 99%
Tricare $242 99%
Aetna $243 - $2,300 100%
Coventry $243 - $4,230 100%
Caresource $246 - $2,314 101%
Kaiser $246 - $1,961 101%
Wellcare $246 101%
Clover Health $250 103%
Pruitt Health Premier $250 103%
Us Dept Of Labor Wc $303 124%
One Call Diagnostics $305 125%
Streamline Imaging $307 126%
Mti $313 128%
Homelink $332 136%
Direct Pay Provider Network Llc $482 198%
Fairly Group $482 198%
Genex/Priority Care Solutions $507 208%
Spreemo $507 208%
Authentic 4D $570 234%
Corvel Workers Comp $602 247%
Employers Choice Network $602 247%
Fieldale Farms Wc $633 260%
Georgia Workers Compensation $633 260%
Medlien Healthcare Services $675 277%
Health One Alliance_Ppo $700 287%
Ambetter / Centene $749 - $1,157 307%
Amerigroup $749 - $885 307%
Medicaid / KanCare $749 - $862 307%
Med Care Solutions $750 308%
Cigna $893 - $1,581 366%
Oscar $1,171 480%
Truths Community $1,199 492%
Good Samaritan Radiology $1,243 510%
Northside Health Network $1,982 813%
Georgia Reproductive Specialists $2,488 1021%
Quick Trip $3,421 1403%
Novanet_Ppo $4,354 1786%
Phcs $4,665 1914%
Beech Steet $5,287 2169%
Multiplan $5,287 2169%
Multiplan Workers Comp $5,287 2169%
Careiq $6,220 2552%
Dekalb_Department Of Health $6,220 2552%
Fifa $6,220 2552%
Institutional Marietta Surgery Center $6,220 2552%
Institutional Veterans Evaluation Services $6,220 2552%
Rabun County Boc $6,220 2552%

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