How many shoppable procedure prices are published for Essentia Health?

Essentia Health in Fargo, ND currently has 133 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Essentia Health's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Essentia Health's median negotiated commercial rate is 0.9× the regionally adjusted fair BaseRate benchmark.

What is Essentia Health's CMS Care Compare overall star rating?

CMS Care Compare assigns Essentia Health an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 142 Beds · rural Updated: 2026-01-01

Essentia Health

3000 32Nd Ave South, Fargo, ND 58104 · 133 Priced Procedures · 75% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Good Deal · Below Fair Market

0.93×vs. Fair Market Price

Typical commercial prices here are 7% below the fair benchmark (0.93×) after accounting for local nurse/doctor wages and patient complexity.

83/100 · Corroborated

83/100Self-Pay Cash Beats Insurance 30% of the Time

File Completeness66

Price Logic95

Peer Alignment66

Clean Billing86

Real Cash Discount100

Regional Value Leader

3-Star CMS clinical quality rating paired with 0.93× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Essentia Health prices shoppable and inpatient services (1.1× to 1.0× Medicare, divergence 0.91×) in alignment with regional hospital peers (0.93× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#5 of 23 in ND · 17th State Percentile#869 of 3,385 in U.S. · 25th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 7% below peer Fair BaseRate (0.93×)
Self-pay cash beats commercial insurance on 30% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (68/100 safety score) with 75% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (46.3% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.93× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Commercial insurance median sits at 0.94× Fair BaseRate (1.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
Even at low-cost facilities (0.93× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Consolidated metro market (HHI 4,926) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.1× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.91× Divergence

1.0× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+3% Upper Tail

Q25 0.83× · Q50 0.94× · Q75 0.97×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.1× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.4× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.5× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.3× MedicareFair

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.5× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

30% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 68/100Fair

Procedure Prices at Essentia Health

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 133 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Total hip replacement CPT Code: `27130`	—	$12,867	$13,413	1.0×
Total knee replacement CPT Code: `27447`	—	$12,867	$13,523	1.0×
Vaginal delivery (full package) CPT Code: `59400`	—	$7,143	$2,680	unverified
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$5,834	$6,109	1.0×
C-section delivery (full package) CPT Code: `59510`	—	$5,615	$2,975	unverified
Breast lump removal CPT Code: `19120`	—	$3,829	$3,875	1.0×
Inguinal hernia repair CPT Code: `49505`	$3,578	$3,529	$3,629	1.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$3,245	$3,372	1.0×
Bunion correction surgery CPT Code: `28296`	—	$3,245	$3,446	0.9×
Cataract surgery with lens implant CPT Code: `66984`	—	$2,281	$2,540	0.9×
Trauma team activation HCPCS Code: `G0390`	$2,311	$1,323	$1,453	0.9×
Colonoscopy with biopsy CPT Code: `45380`	$2,298	$1,179	$1,256	0.9×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,942	$1,017	$1,021	unverified
Upper endoscopy with biopsy CPT Code: `43239`	$2,322	$938	$987	1.0×
Colonoscopy (diagnostic) CPT Code: `45378`	$2,120	$912	$981	0.9×
Injection procedure for pain management HCPCS Code: `G0260`	$1,068	$693	$855	0.8×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,671	$548	$583	0.9×
Blood transfusion CPT Code: `36430`	$659	$437	$498	0.9×
Psychological testing by technician CPT Code: `96138`	—	$399	$395	1.0×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,930	$357	$448	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,113	$357	$511	0.7×
Neurobehavioral status check CPT Code: `96116`	—	$311	$231	1.3×
Rabies immune globulin HCPCS Code: `90375`	$574	$280	$322	0.9×
Behavioral health residential care HCPCS Code: `H0011`	—	$299	$364	0.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,290	$242	$303	0.8×
MRI, brain (no contrast) CPT Code: `70551`	$2,223	$242	$343	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$2,257	$242	$369	0.7×
MRI, lower back (no contrast) CPT Code: `72148`	$2,165	$242	$338	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$981	$242	$272	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$242	$242	$86	unverified
Breathing treatment (nebulizer) CPT Code: `94640`	$159	$203	$201	1.0×
Diagnostic mammogram (both breasts) CPT Code: `77066`	—	$153	$148	1.0×
Psychotherapy session (45 minutes) CPT Code: `90834`	—	$161	$166	1.0×
Family therapy session CPT Code: `90847`	—	$161	$173	0.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	—	$161	$181	0.9×
Psychiatric evaluation (first visit) CPT Code: `90791`	$260	$161	$185	0.9×
CT scan, head (with contrast) CPT Code: `70460`	$1,379	$178	$242	0.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,659	$178	$258	0.7×
Screening mammogram (both breasts) CPT Code: `77067`	—	$124	$123	1.0×
Psychological testing evaluation CPT Code: `96136`	—	$129	$128	1.0×
Hepatitis B immune globulin HCPCS Code: `90371`	$270	$134	$151	0.9×
X-ray, pelvis CPT Code: `72170`	$200	$106	$110	1.0×
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$127	$269	0.5×
X-ray, chest (single view) CPT Code: `71045`	$278	$88	$92	1.0×
X-ray, shoulder CPT Code: `73030`	$265	$88	$92	1.0×
X-ray, foot CPT Code: `73630`	$149	$88	$92	1.0×
X-ray, lower back CPT Code: `72110`	$221	$106	$112	0.9×
X-ray, chest (two views) CPT Code: `71046`	$289	$88	$93	0.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$181	$88	$93	0.9×
X-ray, hand CPT Code: `73130`	$251	$88	$93	0.9×
X-ray, hip CPT Code: `73502`	$281	$88	$93	0.9×
X-ray, ankle CPT Code: `73610`	$147	$88	$93	0.9×
Group therapy session CPT Code: `90853`	—	$93	$100	0.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$545	$106	$126	0.8×
Ultrasound, pelvis CPT Code: `76856`	$572	$106	$130	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$407	$106	$132	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$732	$106	$134	0.8×
CT scan, head (no contrast) CPT Code: `70450`	$1,358	$106	$160	0.7×
CT scan, pelvis CPT Code: `72192`	$1,415	$106	$163	0.7×
CT scan, sinuses CPT Code: `70486`	$1,430	$106	$166	0.6×
CT scan, chest (no contrast) CPT Code: `71250`	$1,415	$106	$167	0.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,515	$106	$168	0.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,645	$106	$169	0.6×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$113	$257	0.4×
New patient office visit (30-44 min) CPT Code: `99203`	$105	$105	$110	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$110	$110	$123	unverified
Typhoid vaccine HCPCS Code: `90675`	$751	$314	$347	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$187	$203	0.9×
Drug screening test HCPCS Code: `G0480`	—	$114	$116	1.0×
Pneumococcal vaccine HCPCS Code: `90732`	—	$133	$140	0.9×
Blood antibody screen CPT Code: `86850`	$150	$53	$46	1.2×
Mental health services (therapy) HCPCS Code: `H0032`	—	$66	$65	1.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$199	$59	$64	0.9×
Speech therapy (language evaluation) CPT Code: `92507`	$213	$75	$86	0.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	$78	$78	$87	unverified
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$42	$35	1.2×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$25	$25	1.0×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$26	$27	1.0×
Flu vaccine injection HCPCS Code: `G0008`	—	$46	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$46	$49	0.9×
Colorectal cancer screening HCPCS Code: `G0010`	—	$46	$49	0.9×
Orthotic fitting and training CPT Code: `97760`	$86	$46	$51	0.9×
Residential substance abuse treatment HCPCS Code: `H2035`	—	$66	$88	0.8×
Mental health services (assessment) HCPCS Code: `H0031`	—	$66	$140	0.5×
Behavioral health assessment HCPCS Code: `H0001`	—	$66	$157	0.4×
Behavioral health living support HCPCS Code: `H2019`	—	$66	$34	unverified
Blood test, comprehensive metabolic panel CPT Code: `80053`	$191	$11	$11	1.0×
Blood test, calcium CPT Code: `82310`	$68	$5	$5	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$165	$14	$14	1.0×
Blood test, sodium CPT Code: `84295`	$67	$5	$5	1.0×
Community mental health services HCPCS Code: `H0038`	—	$16	$16	1.0×
Blood test, vitamin D CPT Code: `82306`	$173	$30	$31	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$40	$3	$3	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$71	$5	$5	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$38	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$75	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$62	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$69	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$62	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$47	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$128	$8	$8	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$119	$19	$20	0.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	$86	$18	$19	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$127	$17	$18	0.9×
Blood test, vitamin B12 CPT Code: `82607`	$108	$15	$16	0.9×
Prosthetic fitting and training CPT Code: `97761`	$46	$40	$45	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$110	$13	$14	0.9×
Blood test, basic metabolic panel CPT Code: `80048`	$104	$8	$9	0.9×
Blood test, liver function panel CPT Code: `80076`	$128	$8	$9	0.9×
Physical therapy (gait training) CPT Code: `97116`	$77	$29	$33	0.9×
Behavioral health outpatient services HCPCS Code: `H2015`	—	$14	$16	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	—	$33	$38	0.9×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$54	$33	unverified
Blood test, amylase CPT Code: `82150`	$78	$6	$7	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	—	$12	$14	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$75	$34	$40	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$74	$32	$38	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$68	$32	$38	0.8×
Hepatitis B vaccine HCPCS Code: `90744`	$53	$31	$37	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$79	$27	$34	0.8×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$88	$40	$56	0.7×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$173	$50	$111	0.5×
Blood test, clotting time (PTT) CPT Code: `85730`	$71	$6	$6	1.0×
Culture, bacterial CPT Code: `87070`	$62	$9	$9	1.0×
Hepatitis C antibody test CPT Code: `86803`	$87	$14	$15	0.9×
Culture, blood CPT Code: `87040`	$169	$10	$11	0.9×
Speech therapy (group session) CPT Code: `92508`	$86	$23	$27	0.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$103	$29	$35	0.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$48	$4	$5	0.8×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$20	$25	0.8×
Blood test, hemoglobin CPT Code: `85018`	$34	$2	$3	0.7×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$54	$16	$39	0.4×
Behavioral health day program HCPCS Code: `H2012`	—	$22	$100	0.2×

Showing top 25 high-impact procedures of 133 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 46.3%

Audit a Bill or Quote at Essentia Health (Zero PHI Required)

CMS CCN: 350070

CPT 27130

Select Procedure to Audit:

Fair BaseRate™ $13,413

Medicare Rate $13,117

Self-Pay Cash Request Quote

Insurer Median $12,867

1. Amount on Your Bill or Quote ($) Pre-filled with Essentia Health’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $14,298 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $14,298

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (46.3% of gross = $14,298).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Essentia Health's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$17,468 Above Fair BaseRate

Negotiate Toward $13,413 Fair BaseRate ($13,117 Medicare)

Your bill ($30,881) is $17,468 above the denoised Fair BaseRate ($13,413) and 2.4× the $13,117 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (46.3% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite68/100

Would Recommend75%

Rated 9 or 10 (HCAHPS)70%

Median ER Wait104 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate4.2%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionbetter

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (586 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Higher-Quality, Above-Median Price Tier Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Essentia Health.

Price Index: 1.12× regional baseline

Quality: 66/100 CMS composite

Median Household Income$75,023U.S. Census ACS

Local Uninsured Share5.7%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 83/100 · Corroborated CMS CCN 350070

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 350070) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-01-01

Validated Rate Rows6,094 (CMS v3.0.0)

File Integrity DigestVerified · CCN 350070

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy

Essentia Health

Aligned Regional Benchmark Peer

Where They're Good (Patient & Payer Edge)

Where You Can Get Burned (Markup Traps)

REA Pricing Decompiler · 5-Layer Cost-to-Charge Reverse Engineering

Insurer Bargaining Power & Cash-Vulnerability Matrix

Procedure Prices at Essentia Health

Audit a Bill or Quote at Essentia Health (Zero PHI Required)

Statutory 501(r) AGB Cap Limits Bill to $14,298

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Negotiate Toward $13,413 Fair BaseRate ($13,117 Medicare)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Clinical Quality, Patient Experience & Infection Benchmarks

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings