CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $11,181
Cash Discount Price: $10,025
vs. Medicare Baseline: 1.81x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at HSHS St Elizabeth's Hospital is $11,181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,025. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 1.81x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.

Cash / Self-Pay

$10,025

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,181

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: $10,025 (162%)

Insurance Median: $11,181 (181%)

Cash: $10,025 (162% of Medicare)

Ins. Median: $11,181 (181% 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
Molina Healthcare	$3,126 - $6,818	51%
Meridian Health Plan	$3,275 - $4,913	53%
Amish Community	$3,899	63%
Aetna	$6,514 - $9,802	105%
Blue Cross Blue Shield	$6,514 - $13,924	105%
Clear Spring Health Of Illinois	$6,514	105%
Health Alliance Medical Plans	$6,514 - $11,835	105%
Health Partners	$6,514	105%
Humana	$6,514	105%
Sae Hospice	$6,514	105%
UnitedHealthcare	$6,514 - $13,924	105%
Wellfirst	$8,965	145%
First Health	$10,359	168%
Cigna	$11,000 - $13,924	178%
Healthlink	$11,069 - $13,924	179%
Caterpillar, Inc.	$11,181	181%
Consociate Group	$12,253	198%
Choicecare	$12,531	203%
Healthcare Finest Network (Hfn)	$12,531	203%
Multiplan/Phcs	$12,531	203%
Provider Network Of America	$12,531	203%
Celtic Insurance Company	$13,015	211%
City Of Springfield	$13,924	225%
Claim Doc	$13,924	225%
Current Health Solutions	$13,924	225%
Healthscope	$13,924	225%
Hopetrust	$13,924	225%
Illinois Breast And Cervical Cancer Program	$13,924	225%
Interplan	$13,924	225%
Live360	$13,924	225%
Wexford	$13,924	225%
Naphcare	$14,116	229%

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 $10,025.
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 HSHS St Elizabeth's Hospital 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.