CMS Price Transparency Data

X-ray, ankle

Facility: Essentia Health St Mary's Medical Center

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $160
Cash Discount Price: $216
vs. Medicare Baseline: 1.80x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Essentia Health St Mary's Medical Center is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.80x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.

Cash / Self-Pay

$216

Average discount available for prompt cash payment at this facility.

Insurance Median

$160

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $216 (243%)

Insurance Median: $160 (180%)

Cash: $216 (243% of Medicare)

Ins. Median: $160 (180% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Advocare/Security Health	$88	99%
Blue Cross Blue Shield	$88 - $249	99%
Freedom Blue Ppo	$88	99%
Healthpartners Care Msho / Mcr Adv	$88	99%
Imcare Msho (Ref Req)	$88	99%
Imcare Msho Pcc Prime	$88	99%
Imcare Msho Ref Req	$88	99%
Itasca Med Care	$88	99%
Medica Advantage Solutions	$88	99%
Medica Msho/Dual Solutions	$88	99%
Medica Prime Solution Group	$88	99%
Medicare (plans)	$88	99%
Nd Va Administration	$88	99%
Platinum Blue / Vantage Blue	$88	99%
Primewest	$88	99%
Primewest Msho	$88	99%
Secure Blue Msho	$88	99%
Ubh Cost Plan	$88	99%
Ubh Msho	$88	99%
Ucare Msho	$88	99%
UnitedHealthcare	$88 - $240	99%
Medica Access	$109	123%
Healthpartners Care Pmap	$131	147%
Sanford Health Plan	$141 - $156	159%
Blue Plus Pmap Pcc Prime	$145 - $164	163%
Medica	$181 - $186	204%
Medica Uplan	$181	204%
Healthpartners	$196 - $235	220%
Medica Choice	$200	225%
Ucare	$216	243%
Cigna	$235	264%
Healthpartners Pcc Prime	$235	264%
Wea	$236 - $253	265%
Security Health	$253	285%
America'S Ppo	$254	286%
Wps	$272 - $276	306%
Aetna	$279	314%
Healthscope Benefits	$279	314%
Healtheos	$282	317%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $216.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Essentia Health St Mary's Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73610.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.