CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Pinckneyville Community Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $6,200
Cash Discount Price: $9,640
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Pinckneyville Community Hospital is $6,200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,640. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 1.00x the Medicare baseline. Located in 5383 State Route 154, Pinckneyville, IL.

Cash / Self-Pay

$9,640

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,200

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: $9,640 (156%)

Insurance Median: $6,200 (100%)

Cash: $9,640 (156% of Medicare)

Ins. Median: $6,200 (100% 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
Umwa Mcr Adv - All Plans	$665 - $6,200	11%
UnitedHealthcare	$665 - $13,740	11%
Wellcare Mcr Adv - All Plans	$665 - $6,200	11%
Aetna	$678 - $18,740	11%
Cigna	$798 - $13,824	13%
Blue Cross Blue Shield	$1,203 - $18,740	19%
Healthlink Hmo	$1,564 - $13,153	25%
Healthlink Ppo - All Other Plans	$1,564 - $13,824	25%
Ambetter / Centene	$1,749 - $18,740	28%
Medicaid / KanCare	$1,749 - $18,740	28%
Phcs Savility	$2,145 - $14,243	35%
Multiplan - All Plans	$2,271 - $15,080	37%
Phcs - All Other Plans	$2,271 - $13,740	37%
Humana	$6,200	100%
Healthlink Work Comp	$13,824	224%

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 $9,640.
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 Pinckneyville 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.