Minnesota / Essentia Health Duluth
CMS certification 240019 · Duluth, MN · 1 entry in CMS's price-transparency list
Essentia Health Duluth: charges and Medicare payments
Essentia Health Duluth reported 265 Medicare inpatient stays across 8 DRGs in 2024. Across them it charged 2.17 times what it was paid — among the lower ratios in Minnesota, number 33 of 43 hospitals with at least 100 stays (state median 2.98×, national 4.15×). Its most frequent stay was DRG 885, Psychoses: 138 stays at an average charge of $34,704, 21% below the national average. It also billed 2,557 outpatient services, charging 3.89 times what Medicare paid.
- 1Medicare inpatient stays 265
- 2Charge ÷ paid, inpatient 2.17×
- 3Rank in MN (highest ratio = 1) 33 of 43
- 4CMS price-transparency actions 1
Inpatient stays
For the 8 DRGs that can be compared with the national average, Essentia Health Duluth charged more than the national average in 0 (0%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 885 Psychoses | 138 | $34,704 | -21% | $14,680 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 37 | $20,523 | -77% | $14,011 |
| 291 Heart Failure and Shock with MCC | 20 | $18,068 | -68% | $10,108 |
| 189 Pulmonary Edema and Respiratory Failure | 17 | $12,440 | -78% | $9,176 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 15 | $10,130 | -75% | $6,351 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 13 | $74,955 | -35% | $20,321 |
| 603 Cellulitis without MCC | 13 | $10,253 | -73% | $7,094 |
| 883 Disorders of Personality and Impulse Control | 12 | $45,497 | -20% | $25,313 |
Outpatient services
Against the Minnesota average
For Psychoses (DRG 885), Essentia Health Duluth charged $34,704 on average, 46% less than the Minnesota average of $64,706, and was paid $14,680 against a state average of $15,086. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Essentia Health Duluth charged $20,523 on average, 65% less than the Minnesota average of $59,297, and was paid $14,011 against a state average of $17,952. For Heart Failure and Shock with MCC (DRG 291), Essentia Health Duluth charged $18,068 on average, 55% less than the Minnesota average of $40,341, and was paid $10,108 against a state average of $11,754. For Pulmonary Edema and Respiratory Failure (DRG 189), Essentia Health Duluth charged $12,440 on average, 70% less than the Minnesota average of $41,872, and was paid $9,176 against a state average of $11,683. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,274 was 18% below the state average of $1,551. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $2,785 was 64% below the state average of $7,743. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $8,916 was 5% above the state average of $8,454. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $4,157 was 43% below the state average of $7,303.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Essentia Health Duluth in Duluth, MN, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-04-22 (CMS case 3974)
A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.
Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.