CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Jefferson County Health Center

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $899
Cash Discount Price: $1,175
vs. Medicare Baseline: 0.15x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Jefferson County Health Center is $899. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,175. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.15x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.

Cash / Self-Pay

$1,175

Average discount available for prompt cash payment at this facility.

Insurance Median

$899

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$6,176.47

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6,176.47 (100%)

Cash / Self-Pay: $1,175 (19%)

Insurance Median: $899 (15%)

Cash: $1,175 (19% of Medicare)

Ins. Median: $899 (15% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6,176.47 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
UnitedHealthcare	$666 - $1,762	11%
Tricare	$760	12%
Amerigroup Mcr Adv	$783	13%
Humana	$783	13%
Iowa Total Care Comm - All Other Plans	$783	13%
Iowa Total Care Mcr	$783	13%
Molina Mcr Adv	$783	13%
Iowa Total Care Mcaid	$822	13%
Molina Mcaid/Chip	$822	13%
Medicaid / KanCare	$839	14%
Aetna	$959 - $1,762	16%
Medicare (plans)	$959	16%
Midlands New Product	$1,606	26%
Coventry Commercial Hmo	$1,664	27%
Coventry Commercial Ppo - All Other Plans	$1,762	29%
Midlands Choice-All Other Plans	$1,762	29%
Molina Marketplace - All Other Plans	$1,958	32%
Wellmark Hmo	$8,655	140%
Wellmark Indemnity/Ppo - All Other Plans	$9,523	154%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,175.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 47562.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Jefferson County Health Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 47562.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.