CMS Price Transparency Data

CT scan, pelvis

Facility: Essentia Health St Mary's Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $851
  • Cash Discount Price: $1,245
  • vs. Medicare Baseline: 7.97x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Essentia Health St Mary's Medical Center is $851. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,245. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.97x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$1,245

Average discount available for prompt cash payment at this facility.

Insurance Median
$851

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: $1,245 (1166%)
Insurance Median: $851 (797%)
Cash: $1,245 (1166% of Medicare)
Ins. Median: $851 (797% 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 797% of the Medicare baseline (a markup of 697%). 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 - $1,434 100%
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 - $1,381 100%
Sanford Health Plan $188 - $852 176%
Medica Access $625 585%
Healthpartners Care Pmap $751 703%
Blue Plus Pmap Pcc Prime $833 - $944 780%
Medica $1,044 - $1,072 977%
Medica Uplan $1,044 977%
Healthpartners $1,130 - $1,349 1058%
Medica Choice $1,153 1079%
Ucare $1,242 1163%
Cigna $1,349 1263%
Healthpartners Pcc Prime $1,349 1263%
Wea $1,359 - $1,453 1272%
Security Health $1,453 1360%
America'S Ppo $1,462 1369%
Wps $1,566 - $1,585 1466%
Aetna $1,604 1502%
Healthscope Benefits $1,604 1502%
Healtheos $1,623 1520%

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