Essentia Health St Mary's Medical Center: charges and Medicare payments

Essentia Health St Mary's Medical Center reported 4,438 Medicare inpatient stays across 137 DRGs in 2024. Across them it charged 3.25 times what it was paid — mid-range in Minnesota, number 16 of 43 hospitals with at least 100 stays (state median 2.98×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 443 stays at an average charge of $45,779, 49% below the national average. It also billed 3,553 outpatient services, charging 5.3 times what Medicare paid.

1Medicare inpatient stays 4,438
2Charge ÷ paid, inpatient 3.25×
3Rank in MN (highest ratio = 1) 16 of 43
4CMS price-transparency actions 1

Average charge per stay at Essentia Health St Mary's Medical Center, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 137 DRGs that can be compared with the national average, Essentia Health St Mary's Medical Center charged more than the national average in 2 (1%). Payments follow Medicare's rates, so they usually vary far less than charges.

DRG	Stays	Avg charge	vs US	Avg paid
871 Septicemia or Severe Sepsis without MV >96 Hours with MCC	443	$45,779	-49%	$15,316
291 Heart Failure and Shock with MCC	192	$34,061	-40%	$10,008
189 Pulmonary Edema and Respiratory Failure	145	$33,966	-41%	$9,696
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	111	$30,444	-45%	$7,855
280 Acute Myocardial Infarction, Discharged Alive with MCC	95	$45,258	-40%	$13,248
266 Endovascular Cardiac Valve Replacement and Supplement...	93	$132,069	-54%	$46,956
378 Gastrointestinal Hemorrhage with CC	93	$26,397	-46%	$7,815
853 Infectious and Parasitic Diseases with O.R. Procedures with...	90	$108,689	-53%	$37,981
321 Percutaneous Cardiovascular Procedures with Intraluminal...	88	$90,456	-45%	$22,321
481 Hip and Femur Procedures except Major Joint with CC	85	$53,948	-46%	$15,866
322 Percutaneous Cardiovascular Procedures with Intraluminal...	82	$72,603	-37%	$14,285
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	81	$53,770	-46%	$15,032
309 Cardiac Arrhythmia and Conduction Disorders with CC	66	$18,079	-50%	$5,865
286 Circulatory Disorders except AMI, with Cardiac...	64	$65,440	-42%	$18,811
274 Percutaneous and Other Intracardiac Procedures without MCC	60	$75,102	-52%	$23,971
377 Gastrointestinal Hemorrhage with MCC	59	$42,067	-51%	$14,223
683 Renal Failure with CC	57	$25,962	-36%	$7,135
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	55	$52,304	-49%	$16,373
267 Endovascular Cardiac Valve Replacement and Supplement...	48	$120,461	-46%	$37,330
682 Renal Failure with MCC	48	$35,435	-46%	$11,923
177 Respiratory Infections and Inflammations with MCC	47	$36,320	-49%	$12,937
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	45	$25,642	-48%	$8,111
698 Other Kidney and Urinary Tract Diagnoses with MCC	44	$31,084	-58%	$12,044
330 Major Small and Large Bowel Procedures with CC	43	$67,276	-43%	$19,874
308 Cardiac Arrhythmia and Conduction Disorders with MCC	41	$27,345	-52%	$9,180
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	41	$20,279	-50%	$6,088
253 Other Vascular Procedures with CC	37	$67,680	-49%	$19,747
480 Hip and Femur Procedures except Major Joint with MCC	37	$65,591	-53%	$21,749
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	36	$43,420	-28%	$11,051
066 Intracranial Hemorrhage or Cerebral Infarction without...	35	$25,521	-40%	$5,362
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	34	$31,624	-51%	$10,597
242 Permanent Cardiac Pacemaker Implant with MCC	34	$95,704	-40%	$28,940
270 Other Major Cardiovascular Procedures with MCC	34	$151,123	-42%	$41,285
329 Major Small and Large Bowel Procedures with MCC	34	$116,601	-46%	$38,201
193 Simple Pneumonia and Pleurisy with MCC	33	$34,194	-43%	$10,119
287 Circulatory Disorders except AMI, with Cardiac...	33	$35,786	-44%	$8,549
394 Other Digestive System Diagnoses with CC	33	$23,051	-51%	$7,573
493 Lower Extremity and Humerus Procedures except Hip, Foot and...	32	$57,023	-52%	$18,152
603 Cellulitis without MCC	32	$23,883	-36%	$6,747
870 Septicemia or Severe Sepsis with MV >96 Hours	32	$165,889	-49%	$55,973
023 Craniotomy with Major Device Implant or Acute Complex Cns...	30	$117,290	-58%	$43,408
521 Hip Replacement with Principal Diagnosis of Hip Fracture...	30	$70,743	-48%	$21,880
243 Permanent Cardiac Pacemaker Implant with CC	28	$62,019	-44%	$17,071
163 Major Chest Procedures with MCC	26	$147,086	-30%	$42,017
236 Coronary Bypass without Cardiac Catheterization without MCC	26	$109,913	-48%	$29,914
025 Craniotomy and Endovascular Intracranial Procedures with MCC	25	$89,835	-61%	$35,072
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	25	$28,903	-53%	$9,745
472 Cervical Spinal Fusion with CC	25	$75,336	-47%	$23,210
690 Kidney and Urinary Tract Infections without MCC	25	$18,726	-50%	$6,254
039 Extracranial Procedures without CC/MCC	24	$33,701	-47%	$8,696
418 Laparoscopic Cholecystectomy without C.D.E. with CC	24	$53,766	-42%	$12,399
617 Amputation of Lower Limb for Endocrine, Nutritional and...	24	$32,819	-62%	$14,855
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	24	$25,342	-32%	$6,450
897 Alcohol, Drug Abuse or Dependence without Rehabilitation...	24	$23,079	-38%	$6,371
269 Aortic and Heart Assist Procedures except Pulsation Balloon...	23	$115,830	-40%	$33,359
389 Gastrointestinal Obstruction with CC	23	$15,951	-59%	$6,181
454 Combined Anterior and Posterior Spinal Fusion with CC	23	$117,263	-58%	$45,368
552 Medical Back Problems without MCC	23	$21,409	-56%	$7,307
054 Nervous System Neoplasms with MCC	22	$47,005	-39%	$11,822
281 Acute Myocardial Infarction, Discharged Alive with CC	22	$27,245	-46%	$6,974

Showing the 60 most frequent of 137 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 1 Endovascular Procedures	382	$18,531	$3,079
Level 2 Upper GI Procedures	330	$8,732	$1,788
Comprehensive Observation Services	304	$12,905	$2,554
Level 3 Electrophysiologic Procedures	237	$91,352	$22,473
Level 3 Vascular Procedures	235	$12,597	$2,991
Level 2 Excision/ Biopsy/ Incision and Drainage	181	$8,999	$1,525
Level 3 Endovascular Procedures	169	$54,299	$10,427
Level 3 Pacemaker and Similar Procedures	135	$40,534	$10,122
Level 1 Laparoscopy and Related Services	121	$28,946	$5,402
Level 2 Laparoscopy and Related Services	115	$38,219	$9,758
Level 4 Urology and Related Services	103	$13,185	$3,307
Level 4 Musculoskeletal Procedures	101	$26,873	$6,733
Level 3 Urology and Related Services	98	$6,725	$1,917
Level 5 Urology and Related Services	91	$17,150	$4,909
Level 2 Endovascular Procedures	90	$28,192	$5,422
Level 4 Airway Endoscopy	89	$19,424	$3,458
Level 3 Excision/ Biopsy/ Incision and Drainage	75	$15,458	$2,638
Level 4 Vascular Procedures	71	$32,270	$5,155
Level 4 Endovascular Procedures	61	$80,678	$16,600
Level 5 Airway Endoscopy	60	$32,421	$6,493
Level 2 Vascular Procedures	52	$4,528	$1,519
Level 5 Musculoskeletal Procedures	51	$44,433	$11,876
Level 4 Pacemaker and Similar Procedures	45	$74,441	$18,443
Level 2 ICD and Similar Procedures	45	$114,359	$31,005
Level 2 Intraocular Procedures	45	$24,897	$3,789

Against the Minnesota average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Essentia Health St Mary's Medical Center charged $45,779 on average, 23% less than the Minnesota average of $59,297, and was paid $15,316 against a state average of $17,952. For Heart Failure and Shock with MCC (DRG 291), Essentia Health St Mary's Medical Center charged $34,061 on average, 16% less than the Minnesota average of $40,341, and was paid $10,008 against a state average of $11,754. For Pulmonary Edema and Respiratory Failure (DRG 189), Essentia Health St Mary's Medical Center charged $33,966 on average, 19% less than the Minnesota average of $41,872, and was paid $9,696 against a state average of $11,683. For Intracranial Hemorrhage or Cerebral Infarction with CC or Tpa in 24 Hours (DRG 065), Essentia Health St Mary's Medical Center charged $30,444 on average, 11% less than the Minnesota average of $34,169, and was paid $7,855 against a state average of $9,351. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $18,531 was 15% above the state average of $16,124. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $8,732 was 18% below the state average of $10,644. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $12,905 was 12% below the state average of $14,738. For Level 3 Electrophysiologic Procedures (outpatient APC 5213), its average charge of $91,352 was 14% below the state average of $106,456.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Essentia Health St Mary's Medical Center 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 — 2023-01-08 (CMS case 1078)

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.