CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Calais Community Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $3,564
Cash Discount Price: $11,043
vs. Medicare Baseline: 0.58x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Calais Community Hospital is $3,564. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,043. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.58x the Medicare baseline. Located in 24 Hospital Lane, Calais, ME.

Cash / Self-Pay

$11,043

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,564

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: $11,043 (179%)

Insurance Median: $3,564 (58%)

Cash: $11,043 (179% of Medicare)

Ins. Median: $3,564 (58% 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
Blue Cross Blue Shield	$303 - $22,217	5%
UnitedHealthcare	$303 - $24,064	5%
Humana	$645 - $12,312	10%
Wellcare	$645 - $12,312	10%
Partners Direct Health	$851 - $16,229	14%
Cigna	$1,234 - $23,532	20%
Aetna	$1,262 - $24,064	20%
Martins Point	$1,320 - $25,183	21%
Harvard Pilgrim	$1,342 - $25,603	22%

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 $11,043.
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 Calais 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.