CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Northside Hospital Forsyth

Billing Code: 73721 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$475

about 1.9× the $244 Medicare rate · typically $240–$1,458

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,491

Well above the fair price

about $1,016 over the fair price · 6.1× Medicare

Medicare pays $244 Fair price $475 This hospital $1,491 Cash price $6,999 Hospital's list price $9,332

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

Highest price of the 9 GA hospitals we have prices for — worth calling around.

Cheapest $159 Priciest $1,491

Black dot = this hospital, among the 9 GA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a MRI, knee or other leg joint is about $475 (about 1.9× the $244 Medicare rate). Northside Hospital Forsyth charges insurers about $1,491, or about $6,999 in cash — well above the fair price. Located in Cumming, GA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $475. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$238 - $2,367	98%
Blue Cross Blue Shieldmajor	$238 - $8,673	98%
Aetnamajor	$243 - $8,461	100%
Cignamajor	$893 - $1,787	366%
Humanamajor	$241 - $547	99%
Kaiser Permanentemajor	$246 - $1,961	101%
Ambetter (Centene)	$749 - $2,314	307%
Amerigroup	$749 - $1,770	307%
CareSource	$246 - $4,629	101%
Clover Health	$250 - $552	103%
Health Net	$1,982	813%
Oscar Health	$1,171	480%
WellCare	$246 - $542	101%
+ 25 smaller / regional plans	$138 - $12,443

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 9 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 6,999), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 73721.

Insurance Before you use insurance

Call your insurance company to confirm Northside Hospital Forsyth is in-network.
Ask your insurer whether prior approval is required for CPT code 73721.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Northside Hospital Forsyth

Compare: MRI, knee or other leg joint at other GA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.