CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: St Joseph's University Medical Center Inc

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $1,360
Cash Discount Price: $2,243
vs. Medicare Baseline: 0.22x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at St Joseph's University Medical Center Inc is $1,360. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,243. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.22x the Medicare baseline. Located in 703 Main St, Paterson, NJ.

Cash / Self-Pay

$2,243

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,360

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: $2,243 (36%)

Insurance Median: $1,360 (22%)

Cash: $2,243 (36% of Medicare)

Ins. Median: $1,360 (22% 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
Aetna	$450 - $14,652	7%
Fidelis Care of New Jersey	$519 - $7,541	8%
UnitedHealthcare	$519 - $9,132	8%
Ambetter / Centene	$692 - $10,773	11%
Amerihealth	$692 - $7,182	11%
Clover Health	$692 - $7,182	11%
Horizon New Jersey Total Care	$692 - $7,182	11%
Wellpoint	$692 - $7,182	11%
Blue Cross Blue Shield	$809 - $20,451	13%
Multiplan	$1,038	17%
Consumer Health Network	$1,079	17%
Private Healthcare Systems	$1,458	24%
Horizon New Jersey Health	$1,906 - $2,969	31%
Cigna	$2,243	36%
Longevity Health Plan	$8,260	134%
Oxford	$8,414	136%

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 $2,243.
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 St Joseph's University Medical Center Inc 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.