CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Essentia Health St Marys - Detroit Lakes

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $988
  • Cash Discount Price: $1,408
  • vs. Medicare Baseline: 9.25x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Essentia Health St Marys - Detroit Lakes is $988. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,408. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.25x the Medicare baseline. Located in 1027 Washington Ave, Detroit Lakes, MN.
Cash / Self-Pay
$1,408

Average discount available for prompt cash payment at this facility.

Insurance Median
$988

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: $1,408 (1318%)
Insurance Median: $988 (925%)
Cash: $1,408 (1318% of Medicare)
Ins. Median: $988 (925% 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 925% of the Medicare baseline (a markup of 825%). 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
Blue Cross Blue Shield $74 - $1,667 69%
Itasca Med Care $106 99%
Primewest $106 99%
Advocare/Security Health $112 105%
Freedom Blue Ppo $112 105%
Healthpartners Care Msho / Mcr Adv $112 105%
Imcare Msho Pcc Prime $112 105%
Imcare Msho Ref Req $112 105%
Medica Advantage Solutions $112 105%
Medica Msho/Dual Solutions $112 105%
Medica Prime Solution Group $112 105%
Medicare (plans) $112 105%
Nd Va Administration $112 105%
Platinum Blue/Vantage Blue $112 105%
Primewest Msho $112 105%
Secure Blue Msho $112 105%
Ubh Cost Plan $112 105%
Ubh Msho $112 105%
Ucare Msho $112 105%
UnitedHealthcare $112 - $1,842 105%
Sanford Healthplan $188 - $990 176%
Healthpartners Care Pmap $853 799%
Medica Uplan $1,395 1306%
Ucare $1,443 1351%
Healthpartners $1,474 - $1,610 1380%
Medica $1,531 - $1,702 1433%
Wea $1,579 - $1,689 1478%
Cigna $1,610 1507%
Healthpartners Pcc Prime $1,610 1507%
America'S Ppo $1,700 1592%
Medica Choice $1,752 1640%
Wps $1,820 - $1,842 1704%
Aetna $1,864 1745%
Healtheos $1,886 1766%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1027 Washington Ave, Detroit Lakes, MN 56501
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals