CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Northwestern Medicine Delnor Community Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $14,606
Cash Discount Price: $23,232
vs. Medicare Baseline: 2.36x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Northwestern Medicine Delnor Community Hospital is $14,606. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23,232. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 2.36x the Medicare baseline. Located in 300 Randall Rd, Geneva, IL.

Cash / Self-Pay

$23,232

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,606

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: $23,232 (376%)

Insurance Median: $14,606 (236%)

Cash: $23,232 (376% of Medicare)

Ins. Median: $14,606 (236% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 236% of the Medicare baseline (a markup of 136%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$3,684	60%
UnitedHealthcare	$7,055 - $22,604	114%
Cigna	$8,476 - $18,083	137%
Blue Cross Blue Shield	$10,373 - $15,760	168%
Carelon Behavioral Health [159]	$11,302	183%
Health'S Finest Network [126]	$11,302 - $19,213	183%
Healthlink [125]	$14,241	231%
The Alliance [1703]	$14,519	235%
First Health Plan [6034]	$15,597	253%
Multiplan/Phcs [142]	$16,953 - $22,604	274%
Compsych [112]	$18,083	293%
Beechstreet [176]	$20,344	329%

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 $23,232.
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 Northwestern Medicine Delnor Community 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.