CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Essentia Health St Mary's Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $1,770
  • Cash Discount Price: $2,591
  • vs. Medicare Baseline: 4.97x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Essentia Health St Mary's Medical Center is $1,770. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,591. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.97x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$2,591

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,770

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $2,591 (727%)
Insurance Median: $1,770 (497%)
Cash: $2,591 (727% of Medicare)
Ins. Median: $1,770 (497% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 497% of the Medicare baseline (a markup of 397%). 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 $357 100%
Advocare/Security Health $358 100%
Blue Cross Blue Shield $358 - $2,984 100%
Freedom Blue Ppo $358 100%
Healthpartners Care Msho / Mcr Adv $358 100%
Imcare Msho (Ref Req) $358 100%
Imcare Msho Pcc Prime $358 100%
Imcare Msho Ref Req $358 100%
Medica Advantage Solutions $358 100%
Medica Msho/Dual Solutions $358 100%
Medica Prime Solution Group $358 100%
Medicare (plans) $358 100%
Nd Va Administration $358 100%
Platinum Blue / Vantage Blue $358 100%
Primewest Msho $358 100%
Secure Blue Msho $358 100%
Ubh Cost Plan $358 100%
Ubh Msho $358 100%
Ucare Msho $358 100%
UnitedHealthcare $358 - $2,874 100%
Primewest $371 104%
Sanford Health Plan $632 - $1,773 177%
Medica Access $1,300 365%
Healthpartners Care Pmap $1,563 439%
Blue Plus Pmap Pcc Prime $1,733 - $1,963 486%
Medica $2,171 - $2,230 609%
Medica Uplan $2,171 609%
Healthpartners $2,352 - $2,807 660%
Medica Choice $2,399 673%
Ucare $2,583 725%
Cigna $2,807 788%
Healthpartners Pcc Prime $2,807 788%
Wea $2,827 - $3,023 793%
Security Health $3,023 848%
America'S Ppo $3,043 854%
Wps $3,259 - $3,298 914%
Aetna $3,337 936%
Healthscope Benefits $3,337 936%
Healtheos $3,376 947%

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