CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Northside Hospital Cherokee

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $107
  • Cash Discount Price: $254
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Northside Hospital Cherokee is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.91x the Medicare baseline. Located in 450 Northside Cherokee Boulevard, Canton, GA.
Cash / Self-Pay
$254

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $254 (216%)
Insurance Median: $107 (91%)
Cash: $254 (216% of Medicare)
Ins. Median: $107 (91% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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
Aetna $73 - $222 62%
Blue Cross Blue Shield $73 - $218 62%
Caresource $73 - $77 62%
Coventry $73 - $161 62%
Humana $73 62%
Kaiser $73 - $139 62%
Medicare (plans) $73 62%
UnitedHealthcare $73 - $230 62%
Va Ccn $73 62%
Wellcare $73 62%
Cigna $75 - $159 64%
Ambetter / Centene $77 - $134 65%
Amerigroup $77 65%
Clear Springs Eon Health $77 65%
Clover Health $77 65%
Pruitt Health Premier $77 65%
Tricare $80 68%
Northside Health Network $97 - $156 83%
Oscar $98 83%
Beech Steet $181 154%
Georgia Workers Compensation $201 171%
Novanet_Ppo $271 231%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 450 Northside Cherokee Boulevard, Canton, GA 30115
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals