CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Essentia Health St Mary's Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $1,324
  • Cash Discount Price: $1,938
  • vs. Medicare Baseline: 5.43x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Essentia Health St Mary's Medical Center is $1,324. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,938. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.43x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$1,938

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,324

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $1,938 (795%)
Insurance Median: $1,324 (543%)
Cash: $1,938 (795% of Medicare)
Ins. Median: $1,324 (543% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 543% of the Medicare baseline (a markup of 443%). 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 $236 97%
Advocare/Security Health $242 99%
Blue Cross Blue Shield $242 - $2,232 99%
Freedom Blue Ppo $242 99%
Healthpartners Care Msho / Mcr Adv $242 99%
Imcare Msho (Ref Req) $242 99%
Imcare Msho Pcc Prime $242 99%
Imcare Msho Ref Req $242 99%
Itasca Med Care $242 99%
Medica Advantage Solutions $242 99%
Medica Msho/Dual Solutions $242 99%
Medica Prime Solution Group $242 99%
Medicare (plans) $242 99%
Nd Va Administration $242 99%
Platinum Blue / Vantage Blue $242 99%
Primewest Msho $242 99%
Secure Blue Msho $242 99%
Ubh Cost Plan $242 99%
Ubh Msho $242 99%
Ucare Msho $242 99%
UnitedHealthcare $242 - $2,150 99%
Sanford Health Plan $428 - $1,326 176%
Medica Access $972 399%
Healthpartners Care Pmap $1,169 480%
Blue Plus Pmap Pcc Prime $1,297 - $1,468 532%
Medica $1,624 - $1,668 666%
Medica Uplan $1,624 666%
Healthpartners $1,759 - $2,100 722%
Medica Choice $1,795 736%
Ucare $1,933 793%
Cigna $2,100 861%
Healthpartners Pcc Prime $2,100 861%
Wea $2,115 - $2,261 868%
Security Health $2,261 928%
America'S Ppo $2,276 934%
Wps $2,438 - $2,467 1000%
Aetna $2,496 1024%
Healthscope Benefits $2,496 1024%
Healtheos $2,526 1036%

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