Essentia Health · Duluth, MN
41
In-network payers
340
Disclosed rate categories
380
Beds
5
Care quality
Essentia Health - St Marys Medical Center is a 380-bed voluntary non-profit - private hospital in Duluth, MN, affiliated with Essentia Health. Below you'll find publicly disclosed negotiated rates and facility details, including 41 in-network payers and 340 disclosed rate categories.
CCN (Medicare provider number)
240002
NPI
1457393035
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Private
Beds
380
Care Quality
5
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Essentia Health - St Marys Medical Center most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Childbirth · Inpatient
MS-DRG 807
$8,320 - $16,800
from 3 insurers · median $10,502
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Childbirth · Inpatient
MS-DRG 788
$12,482 - $20,625
from 3 insurers · median $17,616
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
CT imaging
CPT 74177
$758 - $2,785
from 4 insurers · median $1,769
Common here, based on CMS Medicare volume
CT imaging
CPT 70450
$180 - $1,326
from 4 insurers · median $760
Common here, based on CMS Medicare volume
CT imaging
CPT 74176
$506 - $2,176
from 4 insurers · median $1,347
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 460
$59,701 - $90,211
from 3 insurers · median $74,952
20 Medicare discharges for this DRG in CMS hospital data
CT imaging
CPT 71275
$378 - $2,003
from 4 insurers · median $1,210
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$22,101
negotiated rate
115 Medicare claims in Level 2 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery · Inpatient
MS-DRG 216
$157,516 - $233,301
from 3 insurers · median $204,136
Hospital reports cardiac thoracic surgery services to CMS
MRI imaging
CPT 70553
$614 - $2,874
from 4 insurers · median $1,783
Common here, based on CMS Medicare volume
Childbirth · Inpatient
MS-DRG 807
$8,320 - $16,800
from 3 insurers · median $10,502
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
X-ray and bone density
CPT 71046
$35 - $239
from 4 insurers · median $210
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$233 - $251
from 2 insurers · median $242
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$219 - $1,641
from 4 insurers · median $1,234
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$1,400 - $2,446
from 3 insurers · median $2,390
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 47562
$12,385
negotiated rate
121 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
MRI imaging
CPT 70551
$375 - $2,150
from 4 insurers · median $1,307
Common here, based on CMS Medicare volume
Gynecology
CPT 58558
$2,611 - $6,749
from 3 insurers · median $2,673
15 Medicare claims in Level 4 Gynecologic Procedures (CMS 2024)
MRI imaging
CPT 72148
$279 - $2,073
from 4 insurers · median $1,269
Common here, based on CMS Medicare volume
MRI imaging
CPT 73721
$387 - $2,128
from 4 insurers · median $1,296
Common here, based on CMS Medicare volume
Digestive procedures
CPT 49650
$12,427
negotiated rate
121 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Digestive procedures
CPT 45380
$1,400 - $2,243
from 3 insurers · median $2,191
Common here, based on CMS Medicare volume
Ultrasound
CPT 76705
$156 - $532
from 4 insurers · median $373
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$250 - $2,133
from 4 insurers · median $1,726
Common here, based on CMS Medicare volume
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 20 | 781% | 13 | 2 |
| Insurer B* | 20 | 763% | 16 | 1 |
| Insurer C* | 24 | 211% | 9 | 9 |
| Insurer D* | 13 | 159% | 10 | 1 |
How we chose these services: 5 appear in this hospital's own Medicare claims, 15 are common here based on CMS Medicare volume, and 4 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Essentia Health - St Marys Medical Center.
407 East Third Street, Duluth, MN 55805
(218) 786-4000
The nearest hospitals of similar type and size. Their rates are compared with Essentia Health - St Marys Medical Center for the same insurers and services above.
St. Lukes Hospital Of Duluth
▼ Rates typically 27% lower than Essentia Health - St Marys Medical Center (21 services)
Mercy Hospital
▼ Rates typically 9% lower than Essentia Health - St Marys Medical Center (21 services)
St. Cloud Hospital
▼ Rates typically 24% lower than Essentia Health - St Marys Medical Center (21 services)
St. Josephs Hospital Chippewa Falls
▼ Rates typically 21% lower than Essentia Health - St Marys Medical Center (12 services)
Regions Hospital
▼ Rates typically 37% lower than Essentia Health - St Marys Medical Center (21 services)
North Memorial Health Care
▼ Rates typically 25% lower than Essentia Health - St Marys Medical Center (21 services)
Essentia Health - Duluth
Essentia Health-Virginia
Essentia Health - St. Josephs Medical Center
About Essentia Health - St Marys Medical Center's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Essentia Health - St Marys Medical Center range from $614 to $2,874 across 4 insurers. Blue Cross Blue Shield's rate is $758. The median at nearby comparable hospitals is $951. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Essentia Health - St Marys Medical Center range from $758 to $2,785 across 4 insurers. Aetna's rate is $819. The median at nearby comparable hospitals is $716. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Essentia Health - St Marys Medical Center range from $1,400 to $2,446 across 3 insurers. Blue Cross Blue Shield's rate is $1,400. The median at nearby comparable hospitals is $1,729. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Essentia Health - St Marys Medical Center range from $8,320 to $16,800 across 3 insurers. Cigna's rate is $16,800. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Essentia Health - St Marys Medical Center range from $233 to $251 across 2 insurers. Aetna's rate is $233. The median at nearby comparable hospitals is $199. What a patient pays depends on their plan's deductible, coinsurance and network status.
Essentia Health - St Marys Medical Center has 380 beds. Facility type: Short Term Acute Care Hospital.
Essentia Health - St Marys Medical Center is located at 407 East Third Street, Duluth, MN 55805. Its main phone number is (218) 786-4000.
Essentia Health - St Marys Medical Center's CMS Certification Number (CCN), also called its Medicare provider number, is 240002.
The National Provider Identifier (NPI) on file for Essentia Health - St Marys Medical Center is 1457393035.
Essentia Health - St Marys Medical Center is affiliated with Essentia Health.
Essentia Health - St Marys Medical Center lists 41 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
340 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers