CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Essentia Health St Mary's Medical Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $828
  • Cash Discount Price: $1,213
  • vs. Medicare Baseline: 4.62x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Essentia Health St Mary's Medical Center is $828. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,213. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 4.62x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$1,213

Average discount available for prompt cash payment at this facility.

Insurance Median
$828

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$179.2

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $179.2 (100%)
Cash / Self-Pay: $1,213 (677%)
Insurance Median: $828 (462%)
Cash: $1,213 (677% of Medicare)
Ins. Median: $828 (462% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $179.2 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 462% of the Medicare baseline (a markup of 362%). 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
Primewest $177 99%
Itasca Med Care $178 99%
Advocare/Security Health $179 100%
Blue Cross Blue Shield $179 - $1,397 100%
Freedom Blue Ppo $179 100%
Healthpartners Care Msho / Mcr Adv $179 100%
Imcare Msho (Ref Req) $179 100%
Imcare Msho Pcc Prime $179 100%
Imcare Msho Ref Req $179 100%
Medica Advantage Solutions $179 100%
Medica Msho/Dual Solutions $179 100%
Medica Prime Solution Group $179 100%
Medicare (plans) $179 100%
Nd Va Administration $179 100%
Platinum Blue / Vantage Blue $179 100%
Primewest Msho $179 100%
Secure Blue Msho $179 100%
Ubh Cost Plan $179 100%
Ubh Msho $179 100%
Ucare Msho $179 100%
UnitedHealthcare $179 - $1,345 100%
Sanford Health Plan $315 - $830 176%
Medica Access $608 339%
Healthpartners Care Pmap $732 408%
Blue Plus Pmap Pcc Prime $811 - $919 453%
Medica $1,016 - $1,044 567%
Medica Uplan $1,016 567%
Healthpartners $1,101 - $1,314 614%
Medica Choice $1,123 627%
Ucare $1,209 675%
Cigna $1,314 733%
Healthpartners Pcc Prime $1,314 733%
Wea $1,323 - $1,415 738%
Security Health $1,415 790%
America'S Ppo $1,424 795%
Wps $1,526 - $1,544 852%
Aetna $1,562 872%
Healthscope Benefits $1,562 872%
Healtheos $1,581 882%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals