CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Northside Hospital Forsyth

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $243
  • Cash Discount Price: $682
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Northside Hospital Forsyth is $243. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $682. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.92x the Medicare baseline. Located in 1200 Northside Forsyth Drive, Cumming, GA.
Cash / Self-Pay
$682

Average discount available for prompt cash payment at this facility.

Insurance Median
$243

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)
Cash / Self-Pay: $682 (540%)
Insurance Median: $243 (192%)
Cash: $682 (540% of Medicare)
Ins. Median: $243 (192% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $126.25 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.

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
Blue Cross Blue Shield $44 - $696 35%
Clear Springs Eon Health $44 - $88 35%
Humana $44 - $91 35%
Medicare (plans) $44 - $107 35%
UnitedHealthcare $44 - $308 35%
Va Ccn $44 - $88 35%
Aetna $45 - $299 36%
Caresource $45 - $371 36%
Coventry $45 - $679 36%
Kaiser $45 - $285 36%
Wellcare $45 - $90 36%
Clover Health $46 - $92 36%
Pruitt Health Premier $46 - $92 36%
Fairly Group $50 - $101 40%
Us Dept Of Labor Wc $56 - $112 44%
Cbww $80 - $124 63%
Medlien Healthcare Services $85 67%
Champus Va $89 70%
Tricare $89 70%
Bccp $96 76%
Ambetter / Centene $99 - $288 78%
Amerigroup $99 - $142 78%
Medicaid / KanCare $99 - $138 78%
Cigna $118 - $286 93%
East Georgia Cancer Coalition $123 - $150 97%
Clarkston Community Health $140 111%
Truths Community $157 124%
Good Samaritan Radiology $164 - $199 130%
Mti $222 176%
One Call Diagnostics $222 176%
Streamline Imaging $229 181%
Homelink $236 187%
Oscar $237 188%
Northside Health Network $274 217%
Georgia Reproductive Specialists $328 - $399 260%
Med Care Solutions $369 - $449 292%
Health One Alliance_Ppo $452 - $549 358%
Quick Trip $452 - $549 358%
Novanet_Ppo $575 - $699 455%
Phcs $616 - $748 488%
Beech Steet $698 - $848 553%
Multiplan $698 - $848 553%
Multiplan Workers Comp $698 - $848 553%
Careiq $821 - $998 650%
Dekalb_Department Of Health $821 - $998 650%
Fifa $821 - $998 650%
Institutional Marietta Surgery Center $821 - $998 650%
Institutional Veterans Evaluation Services $821 - $998 650%
Rabun County Boc $821 - $998 650%

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