CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Essentia Health St Mary's Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $1,034
  • Cash Discount Price: $1,515
  • vs. Medicare Baseline: 9.68x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Essentia Health St Mary's Medical Center is $1,034. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,515. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.68x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$1,515

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,034

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $1,515 (1418%)
Insurance Median: $1,034 (968%)
Cash: $1,515 (1418% of Medicare)
Ins. Median: $1,034 (968% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 968% of the Medicare baseline (a markup of 868%). 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
Itasca Med Care $106 99%
Primewest $106 99%
Advocare/Security Health $107 100%
Blue Cross Blue Shield $107 - $1,744 100%
Freedom Blue Ppo $107 100%
Healthpartners Care Msho / Mcr Adv $107 100%
Imcare Msho (Ref Req) $107 100%
Imcare Msho Pcc Prime $107 100%
Imcare Msho Ref Req $107 100%
Medica Advantage Solutions $107 100%
Medica Msho/Dual Solutions $107 100%
Medica Prime Solution Group $107 100%
Medicare (plans) $107 100%
Nd Va Administration $107 100%
Platinum Blue / Vantage Blue $107 100%
Primewest Msho $107 100%
Secure Blue Msho $107 100%
Ubh Cost Plan $107 100%
Ubh Msho $107 100%
Ucare Msho $107 100%
UnitedHealthcare $107 - $1,680 100%
Sanford Health Plan $188 - $1,036 176%
Medica Access $760 712%
Healthpartners Care Pmap $913 855%
Blue Plus Pmap Pcc Prime $1,013 - $1,148 948%
Medica $1,269 - $1,304 1188%
Medica Uplan $1,269 1188%
Healthpartners $1,375 - $1,641 1287%
Medica Choice $1,402 1313%
Ucare $1,510 1414%
Cigna $1,641 1536%
Healthpartners Pcc Prime $1,641 1536%
Wea $1,652 - $1,767 1547%
Security Health $1,767 1654%
America'S Ppo $1,779 1666%
Wps $1,905 - $1,928 1784%
Aetna $1,951 1827%
Healthscope Benefits $1,951 1827%
Healtheos $1,974 1848%

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