Gallbladder removal (laparoscopic)
Facility: Nmc Health
Billing Code: 47562 (CPT)
- CPT Billing Code: 47562
- Insurance Median: $5,309
- Cash Discount Price: $5,655
- vs. Medicare Baseline: 0.86x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bluestem Pace | $551 - $5,309 | 9% |
| Wppa | $730 - $8,155 | 12% |
| Occunet | $796 - $8,897 | 13% |
| Samaritan Ministries International | $863 - $9,638 | 14% |
| Medincrease Health Plan | $863 - $9,638 | 14% |
| Medicaid / KanCare | $882 - $8,494 | 14% |
| Leading Age | $882 - $8,494 | 14% |
| Prime Health Services | $995 - $11,121 | 16% |
| Aetna | $1,093 - $8,604 | 18% |
| UnitedHealthcare | $1,194 - $13,345 | 19% |
| Cigna | $1,261 - $14,087 | 20% |
| Blue Cross Blue Shield | $6,872 | 111% |
Consumer Guidance & Cost Commentary
For the gallbladder removal (laparoscopic) procedure at Nmc Health in Newton, KS, the cash price is $5,655.00, which is lower than the facility's gross charge of $8,741.00. While the facility does not provide a specific county or state average for this code in the provided data, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, the median negotiated rate across payers is $5,309.00, which is slightly lower than the cash price, but individual negotiated rates can vary significantly; for example, UnitedHealthcare's high-end negotiated rate reaches $14,087.00, while Blue Cross Blue Shield's fixed rate is $6,872.00. If you have a high-deductible plan, paying the cash price directly may result in lower out-of-pocket costs compared to your insurance paying its negotiated rate, especially if your deductible has not yet been met.
To ensure you receive the most accurate and transparent pricing, it is essential to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, patients should inquire about prompt-pay discounts, which can reduce the cash price by 20% to 50% if paid upfront, effectively bypassing the costly insurance claims cycle. If you encounter a balance bill from an out-of-network provider, such as emergency services or ancillary labs, the No Surprises Act generally protects you from paying the difference between the provider's full charge and your insurance allowed