CMS Price Transparency Data

X-ray, lower back

Facility: Essentia Health St Mary's Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $224
  • Cash Discount Price: $327
  • vs. Medicare Baseline: 2.10x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Essentia Health St Mary's Medical Center is $224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $327. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.10x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$327

Average discount available for prompt cash payment at this facility.

Insurance Median
$224

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: $327 (306%)
Insurance Median: $224 (210%)
Cash: $327 (306% of Medicare)
Ins. Median: $224 (210% 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 210% of the Medicare baseline (a markup of 110%). 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 - $377 100%
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 - $363 100%
Medica Access $164 154%
Sanford Health Plan $188 - $224 176%
Healthpartners Care Pmap $197 184%
Blue Plus Pmap Pcc Prime $219 - $248 205%
Medica $274 - $282 257%
Medica Uplan $274 257%
Healthpartners $297 - $355 278%
Medica Choice $303 284%
Ucare $326 305%
Cigna $355 332%
Healthpartners Pcc Prime $355 332%
Wea $357 - $382 334%
Security Health $382 358%
America'S Ppo $384 360%
Wps $412 - $417 386%
Aetna $422 395%
Healthscope Benefits $422 395%
Healtheos $427 400%

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