CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Essentia Health St Mary's Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,310
  • Cash Discount Price: $1,919
  • vs. Medicare Baseline: 5.37x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Essentia Health St Mary's Medical Center is $1,310. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,919. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.37x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$1,919

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,310

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: $1,919 (787%)
Insurance Median: $1,310 (537%)
Cash: $1,919 (787% of Medicare)
Ins. Median: $1,310 (537% 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 537% of the Medicare baseline (a markup of 437%). 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 - $2,209 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 - $2,128 99%
Sanford Health Plan $428 - $1,313 176%
Medica Access $962 395%
Healthpartners Care Pmap $1,157 475%
Blue Plus Pmap Pcc Prime $1,283 - $1,454 526%
Medica $1,608 - $1,651 660%
Medica Uplan $1,608 660%
Healthpartners $1,741 - $2,078 714%
Medica Choice $1,776 729%
Ucare $1,913 785%
Cigna $2,078 852%
Healthpartners Pcc Prime $2,078 852%
Wea $2,093 - $2,238 859%
Security Health $2,238 918%
America'S Ppo $2,253 924%
Wps $2,413 - $2,442 990%
Aetna $2,471 1014%
Healthscope Benefits $2,471 1014%
Healtheos $2,500 1026%

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