CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Hermann Area District Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $2,385
Cash Discount Price: $2,487
vs. Medicare Baseline: 0.39x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Hermann Area District Hospital is $2,385. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,487. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.39x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.

Cash / Self-Pay

$2,487

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,385

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: $2,487 (40%)

Insurance Median: $2,385 (39%)

Cash: $2,487 (40% of Medicare)

Ins. Median: $2,385 (39% 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
Care Partners Mcaid- All Plans	$562	9%
UnitedHealthcare	$1,593 - $2,385	26%
Tricare	$1,617 - $1,665	26%
Choicecare Mcr Adv- All Plans	$1,715 - $1,766	28%
American Hlth Mcr Adv- All Plans	$1,797 - $1,850	29%
Blue Cross Blue Shield	$1,797 - $2,805	29%
Humana	$1,797 - $1,850	29%
Aetna	$1,833 - $3,995	30%
Wellcare Mcr Adv - All Plans	$1,833 - $1,887	30%
Healthy Blue Mcaid - All Plans	$2,211	36%
Ambetter / Centene	$2,298 - $2,961	37%
Harmony Hp Mcaid- All Plans	$2,368 - $2,439	38%
Healthcare Usa Mcaid- All Plans	$2,654 - $2,734	43%
Multiplan/Phcs - All Plans	$3,063 - $3,154	50%
Coventry - All Plans	$3,471 - $3,575	56%
Healthlink Hmo	$3,605	58%
Healthlink Ppo - All Other Plans	$3,605	58%
Comp Results - All Plans	$3,675 - $3,785	60%
Three Rivers - All Plans	$3,675 - $3,785	60%

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 $2,487.
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 Hermann Area District 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.