CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Saint Clare's Hospital/ Denville Campus

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $7,362
Cash Discount Price: $7,010
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Saint Clare's Hospital/ Denville Campus is $7,362. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,010. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 1.19x the Medicare baseline. Located in 25 Pocono Road, Denville, NJ.

Cash / Self-Pay

$7,010

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,362

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: $7,010 (113%)

Insurance Median: $7,362 (119%)

Cash: $7,010 (113% of Medicare)

Ins. Median: $7,362 (119% 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
Brighton Health Plan Solutions (Fka Magnacare)	$5,151	83%
UnitedHealthcare	$5,161 - $8,190	84%
Humana	$5,609	91%
Aetna	$7,011 - $14,863	114%
Amerihealth	$7,011	114%
Clover Health	$7,011	114%
Horizon	$7,011 - $14,576	114%
Medicare (plans)	$7,011	114%
Tricare	$7,011	114%
Wellcare	$7,011 - $9,465	114%
Wellpoint Amerigroup	$7,011	114%
Ally-Align (Fka Spartan Health Plan)	$7,362	119%
Employer Direct Healthcare	$9,815	159%
Cigna	$10,835	175%
Fairprice Healthcare Holdings - Fphh	$11,218	182%
Coventry	$14,022	227%

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 $7,010.
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 Saint Clare's Hospital/ Denville Campus 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.