CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Holton Community Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 47562
  • Insurance Median: $1,231
  • Cash Discount Price: $1,425
  • vs. Medicare Baseline: 0.20x Medicare
The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Holton Community Hospital is $1,231. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,425. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.20x the Medicare baseline. Located in 1110 Columbine Drive, Holton, KS.
Cash / Self-Pay
$1,425

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,231

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: $1,425 (23%)
Insurance Median: $1,231 (20%)
Cash: $1,425 (23% of Medicare)
Ins. Median: $1,231 (20% 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.

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
UnitedHealthcare $568 - $7,311 9%
Aetna $568 - $7,311 9%
Humana $574 - $3,914 9%
Kansas Superior Select - All Plans $580 - $3,952 9%
Medicaid / KanCare $583 - $7,311 9%
Preferred Health Freedom $1,048 - $6,068 17%
Preferred Health Fn Select - All Other Plans $1,048 - $6,068 17%
Preferred Health Professionals $1,048 - $6,068 17%
Wppa Providers - All Plans $1,200 - $6,945 19%
Blue Cross Blue Shield $4,826 78%

Consumer Guidance & Cost Commentary

For a gallbladder removal (laparoscopic) at Holton Community Hospital in Holton, KS, the cash median price is $1,425, while the facility's negotiated rates with insurance payers range from $568 to $7,311. The cash price is notably lower than the median negotiated rate of $3,952, which suggests that patients with high-deductible plans might save money by paying out-of-pocket, provided they can secure a self-pay or prompt-pay discount. It is important to note that while the facility is a Critical Access Hospital in Kansas, the specific county or state average data for this procedure was not included in the provided information, so direct regional comparisons cannot be made.

The Medicare benchmark for this service is $6,176.47, which serves as a scientifically validated baseline for evaluating pricing markups. Commercial negotiated rates often exceed this benchmark due to administrative costs and contract structures, but the cash price of $1,425 represents a significant reduction compared to the Medicare amount. To ensure you receive the best possible rate, we recommend requesting an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if paid in full upfront, effectively bypassing the higher administrative fees associated with insurance claims processing.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1110 Columbine Drive, Holton, KS 66436
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals