CMS Price Transparency Data

X-ray, ankle

Facility: Northside Hospital Forsyth

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73610
  • Insurance Median: $509
  • Cash Discount Price: $808
  • vs. Medicare Baseline: 5.72x Medicare
The contracted insurance negotiated median rate for a X-ray, ankle at Northside Hospital Forsyth is $509. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $808. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.72x the Medicare baseline. Located in 1200 Northside Forsyth Drive, Cumming, GA.
Cash / Self-Pay
$808

Average discount available for prompt cash payment at this facility.

Insurance Median
$509

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $808 (909%)
Insurance Median: $509 (572%)
Cash: $808 (909% of Medicare)
Ins. Median: $509 (572% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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 572% of the Medicare baseline (a markup of 472%). 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 $27 - $54 30%
Lantern $37 42%
Oscar $48 54%
Ambetter / Centene $51 - $255 57%
Blue Cross Blue Shield $67 - $956 75%
Mti $67 75%
One Call Diagnostics $67 - $135 75%
Streamline Imaging $68 76%
Homelink $72 81%
Truths Community $83 93%
Clear Springs Eon Health $87 98%
Medicare (plans) $87 - $106 98%
UnitedHealthcare $87 - $969 98%
Va Ccn $87 98%
Bccp $88 99%
Cbww $88 99%
Humana $88 - $90 99%
Tricare $88 99%
Aetna $89 - $932 100%
Coventry $89 - $932 100%
Caresource $90 - $510 101%
Kaiser $90 - $1,193 101%
Wellcare $90 101%
Clover Health $91 102%
Pruitt Health Premier $91 102%
Amerigroup $94 - $195 106%
Medicaid / KanCare $94 - $190 106%
Fairly Group $100 112%
Us Dept Of Labor Wc $110 124%
Cigna $112 - $864 126%
Good Samaritan Radiology $156 - $274 175%
Med Care Solutions $160 180%
Medlien Healthcare Services $160 180%
Genex/Priority Care Solutions $185 - $369 208%
Spreemo $185 208%
Authentic 4D $208 234%
Direct Pay Provider Network Llc $208 234%
Corvel Workers Comp $219 - $438 246%
Employers Choice Network $219 - $438 246%
Northside Health Network $219 - $384 246%
Fieldale Farms Wc $231 260%
Georgia Workers Compensation $231 - $461 260%
Georgia Reproductive Specialists $313 - $548 352%
Health One Alliance_Ppo $431 - $754 485%
Quick Trip $431 - $754 485%
Novanet_Ppo $548 - $960 616%
Phcs $587 - $1,028 660%
Beech Steet $666 - $1,165 749%
Multiplan $666 - $1,165 749%
Multiplan Workers Comp $666 - $1,165 749%
Careiq $783 - $1,371 881%
Dekalb_Department Of Health $783 - $1,371 881%
Fifa $783 - $1,371 881%
Institutional Marietta Surgery Center $783 - $1,371 881%
Institutional Veterans Evaluation Services $783 - $1,371 881%
Rabun County Boc $783 - $1,371 881%

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