CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Essentia Health St Mary's Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $170
  • Cash Discount Price: $240
  • vs. Medicare Baseline: 1.91x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Essentia Health St Mary's Medical Center is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $240. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.91x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$240

Average discount available for prompt cash payment at this facility.

Insurance Median
$170

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: $240 (270%)
Insurance Median: $170 (191%)
Cash: $240 (270% of Medicare)
Ins. Median: $170 (191% 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.

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 - $277 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 - $266 99%
Medica Access $120 135%
Healthpartners Care Pmap $145 163%
Sanford Health Plan $156 - $164 175%
Blue Plus Pmap Pcc Prime $161 - $182 181%
Medica $201 - $207 226%
Medica Uplan $201 226%
Healthpartners $218 - $260 245%
Medica Choice $222 250%
Ucare $240 270%
Cigna $260 292%
Healthpartners Pcc Prime $260 292%
Wea $262 - $280 295%
Security Health $280 315%
America'S Ppo $282 317%
Wps $302 - $306 340%
Aetna $309 348%
Healthscope Benefits $309 348%
Healtheos $313 352%

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