CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $3,418
Cash Discount Price: $1,729
vs. Medicare Baseline: 0.55x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Nationwide Children's Hospital Toledo, LLC is $3,418. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,729. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.55x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.

Cash / Self-Pay

$1,729

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,418

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: $1,729 (28%)

Insurance Median: $3,418 (55%)

Cash: $1,729 (28% of Medicare)

Ins. Median: $3,418 (55% 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
Mcclaren Health Plan - Michigan	$440 - $6,362	7%
Tricare	$600 - $5,543	10%
Caresource	$615 - $6,485	10%
Paramount	$615	10%
Blue Cross Blue Shield	$646 - $3,451	10%
Front Path Health Coalition	$800 - $18,529	13%
Mcclaren Health Plan	$861	14%
Aetna	$1,105	18%
UnitedHealthcare	$1,152 - $3,418	19%
Cigna	$2,094	34%
Ohc	$2,161	35%
Ohio Ppo Connect	$2,161	35%
Mmo	$2,881	47%
Molina	$3,418 - $7,001	55%
Amerihealth	$3,451	56%
Bchp	$3,451	56%
Humana	$3,451	56%

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 $1,729.
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 Nationwide Children's Hospital Toledo, LLC 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.