CMS Price Transparency Data

X-ray, chest (two views)

Facility: Northside Hospital Forsyth

Billing Code: 71046 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71046
  • Insurance Median: $400
  • Cash Discount Price: $632
  • vs. Medicare Baseline: 4.50x Medicare
The contracted insurance negotiated median rate for a X-ray, chest (two views) at Northside Hospital Forsyth is $400. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $632. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.50x the Medicare baseline. Located in 1200 Northside Forsyth Drive, Cumming, GA.
Cash / Self-Pay
$632

Average discount available for prompt cash payment at this facility.

Insurance Median
$400

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: $632 (711%)
Insurance Median: $400 (450%)
Cash: $632 (711% of Medicare)
Ins. Median: $400 (450% 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 450% of the Medicare baseline (a markup of 350%). 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
Dekalb_Department Of Health $17 - $843 19%
Champus Va $23 26%
Lantern $37 42%
Oscar $39 44%
Ambetter / Centene $45 - $157 51%
Hall District 2 Public Health $46 52%
Blue Cross Blue Shield $54 - $588 61%
Streamline Imaging $55 62%
Mti $56 63%
One Call Diagnostics $56 63%
Homelink $60 67%
Truths Community $83 93%
Clear Springs Eon Health $87 98%
Medicare (plans) $87 - $106 98%
UnitedHealthcare $87 - $596 98%
Va Ccn $87 98%
Bccp $88 99%
Cbww $88 99%
Humana $88 - $90 99%
Tricare $88 99%
Aetna $89 - $573 100%
Coventry $89 - $573 100%
Caresource $90 - $314 101%
Kaiser $90 - $733 101%
Wellcare $90 101%
Clover Health $91 102%
Pruitt Health Premier $91 102%
Fairly Group $100 112%
Amerigroup $102 - $120 115%
Medicaid / KanCare $102 - $117 115%
Us Dept Of Labor Wc $110 124%
Cigna $121 - $531 136%
West Paces Imaging Agreement $145 163%
Good Samaritan Radiology $168 189%
Genex/Priority Care Solutions $185 208%
Spreemo $185 208%
Authentic 4D $208 234%
Direct Pay Provider Network Llc $208 234%
Corvel Workers Comp $219 246%
Employers Choice Network $219 246%
Fieldale Farms Wc $231 260%
Georgia Workers Compensation $231 260%
Northside Health Network $236 265%
Georgia Reproductive Specialists $337 379%
Medlien Healthcare Services $337 379%
Med Care Solutions $379 426%
Health One Alliance_Ppo $464 522%
Quick Trip $464 522%
Novanet_Ppo $590 664%
Phcs $632 711%
Beech Steet $717 806%
Multiplan $717 806%
Multiplan Workers Comp $717 806%
Careiq $843 948%
Fifa $843 948%
Institutional Marietta Surgery Center $843 948%
Institutional Veterans Evaluation Services $843 948%
Rabun County Boc $843 948%

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