CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: St Anthony Regional Hospital & Nursing Home

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $892
Cash Discount Price: $1,894
vs. Medicare Baseline: 0.14x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at St Anthony Regional Hospital & Nursing Home is $892. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,894. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.14x the Medicare baseline. Located in 311 South Clark Street, Carroll, IA.

Cash / Self-Pay

$1,894

Average discount available for prompt cash payment at this facility.

Insurance Median

$892

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: $1,894 (31%)

Insurance Median: $892 (14%)

Cash: $1,894 (31% of Medicare)

Ins. Median: $892 (14% 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
Midlands Choice - All Plans	$77	1%
Aetna	$561 - $1,247	9%
Humana	$561 - $1,610	9%
Medica Mcr - All Plans	$561	9%
UnitedHealthcare	$561 - $898	9%
Va Ccn - All Plans	$561	9%
Wellpoint Mcr Adv	$561	9%
Ia Total Care Mcr	$578	9%
Ia Total Care Comm - All Other Plans	$729	12%
Wellmark Hmo	$1,287	21%
Wellmark Ppo-All Other Plans	$1,514	25%
Ia Total Care Mcaid	$1,894	31%
Wellpoint Mcaid - All Other Plans	$1,894	31%
Molina Mcaid - All Plans	$1,932	31%

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 $1,894.
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 St Anthony Regional Hospital & Nursing Home 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.