CMS Price Transparency Data
Gallbladder removal (laparoscopic)
Facility: St Charles Medical Center Prineville
Billing Code: 47562 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 47562
- Insurance Median: $12,583
- Cash Discount Price: $11,624
- vs. Medicare Baseline: 2.04x Medicare
The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at St Charles Medical Center Prineville is $12,583. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,624. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 2.04x the Medicare baseline. Located in 384 Se Combs Flat Road, Prineville, OR.
Cash / Self-Pay
$11,624
Average discount available for prompt cash payment at this facility.
Insurance Median
$12,583
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: $11,624 (188%)
Insurance Median: $12,583 (204%)
Cash: $11,624 (188% of Medicare)
Ins. Median: $12,583 (204% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 204% of the Medicare baseline (a markup of 104%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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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 | $4,016 - $12,679 | 65% |
| Ageright Advantage [142] | $4,016 - $4,081 | 65% |
| Champ Va [700] | $4,016 - $4,081 | 65% |
| Cigna | $4,016 - $9,181 | 65% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $4,016 - $4,081 | 65% |
| Devoted Health Inc [145] | $4,016 - $4,081 | 65% |
| Health Market Care Assured [134] | $4,016 - $4,081 | 65% |
| Health Net Med Adv [135] | $4,016 - $4,081 | 65% |
| Humana | $4,016 - $4,081 | 65% |
| Indian Health [704] | $4,016 - $4,081 | 65% |
| Kaiser Permanente Med Adv [136] | $4,016 - $4,081 | 65% |
| Law Enforcement [701] | $4,016 - $7,229 | 65% |
| Medicare (plans) | $4,016 - $4,734 | 65% |
| Samaritan Health Plan Med Adv [141] | $4,016 - $4,081 | 65% |
| Unicare [133] | $4,016 - $4,081 | 65% |
| UnitedHealthcare | $4,016 - $13,468 | 65% |
| Veterans [706] | $4,016 - $4,081 | 65% |
| Wellcare [132] | $4,016 - $4,081 | 65% |
| Tricare | $4,376 - $4,447 | 71% |
| Blue Cross Blue Shield | $4,417 - $18,660 | 72% |
| Advanced Health [534] | $5,020 - $5,101 | 81% |
| Allcare Health Plan [538] | $5,020 - $5,101 | 81% |
| Cascade Health Alliance [532] | $5,020 - $5,101 | 81% |
| Columbia Pacific Coordinated Care Llc [539] | $5,020 - $5,101 | 81% |
| Health Share Care Oregon [526] | $5,020 - $5,101 | 81% |
| Health Share Kaiser [543] | $5,020 - $5,101 | 81% |
| Health Share Ohsu Ohp [552] | $5,020 - $5,101 | 81% |
| Health Share Providence [548] | $5,020 - $5,101 | 81% |
| Health Share [537] | $5,020 - $5,101 | 81% |
| Intercommunity Health [530] | $5,020 - $5,101 | 81% |
| Jackson Care Connect [542] | $5,020 - $5,101 | 81% |
| Medicaid / KanCare | $5,020 - $5,101 | 81% |
| Primary Health Of Jospehine County Llc [547] | $5,020 - $5,101 | 81% |
| Umpqua Health [533] | $5,020 - $5,101 | 81% |
| Willamette Valley Community Health [536] | $5,020 - $5,101 | 81% |
| Yamhill County Coordinated Care Org [550] | $5,020 - $5,101 | 81% |
| Us Benefits [326] | $9,036 - $9,181 | 146% |
| Providence Health Plan [347] | $10,039 - $12,752 | 163% |
| Rocky Mountain Administrators [405] | $11,474 - $11,659 | 186% |
| Rx Internal [4100003] | $11,718 - $11,907 | 190% |
| First Choice Health [317] | $12,420 - $12,621 | 201% |
| Kaiser Permanente [334] | $12,420 - $12,621 | 201% |
| Samaritan [376] | $12,420 - $12,621 | 201% |
| Meritain Health [300] | $12,478 - $12,679 | 202% |
| Health Net [340] | $13,482 - $13,699 | 218% |
| Administrative Concepts Inc [402] | $14,055 - $14,282 | 228% |
| First Health [339] | $14,055 - $14,282 | 228% |
| Manhattan Life Insurance Company [379] | $14,055 - $14,282 | 228% |
| Philadelphia American Life Insurance Company [395] | $14,055 - $14,282 | 228% |
| Planned Administrators Inc [375] | $14,055 - $14,282 | 228% |
| Auto Allstate Insurance [602] | $14,342 - $14,574 | 232% |
| Auto American Family Insurance [603] | $14,342 - $14,574 | 232% |
| Auto Country Insurance Claims [604] | $14,342 - $14,574 | 232% |
| Auto Dairyland Insurance [617] | $14,342 - $14,574 | 232% |
| Auto Farmers [605] | $14,342 - $14,574 | 232% |
| Auto Geico Claims Oregon [606] | $14,342 - $14,574 | 232% |
| Auto Hartford [612] | $14,342 - $14,574 | 232% |
| Auto Liberty Mutual Auto Ins [613] | $14,342 - $14,574 | 232% |
| Auto Mutual Of Enumclaw [610] | $14,342 - $14,574 | 232% |
| Auto Nationwide Allied Insuranc [601] | $14,342 - $14,574 | 232% |
| Auto Oregon Mutual [614] | $14,342 - $14,574 | 232% |
| Auto Progressive [608] | $14,342 - $14,574 | 232% |
| Auto Safeco Concentra [600] | $14,342 - $14,574 | 232% |
| Auto State Farm Claims [609] | $14,342 - $14,574 | 232% |
| Auto Sublimity Insurance [616] | $14,342 - $14,574 | 232% |
| Auto Travelers Insurance [615] | $14,342 - $14,574 | 232% |
| Auto Usaa [611] | $14,342 - $14,574 | 232% |
| Generic Auto [649] | $14,342 - $14,574 | 232% |
| Generic Workers Comp [699] | $14,342 - $14,574 | 232% |
| Otj Broadspire Services [670] | $14,342 - $14,574 | 232% |
| Otj Ccmsi [618] | $14,342 - $14,574 | 232% |
| Otj Chartis Claims [650] | $14,342 - $14,574 | 232% |
| Otj City County Ins Services [662] | $14,342 - $14,574 | 232% |
| Otj Corvel [676] | $14,342 - $14,574 | 232% |
| Otj Esis West Wc Claims [653] | $14,342 - $14,574 | 232% |
| Otj Gallagher Bassett [654] | $14,342 - $14,574 | 232% |
| Otj Hartford [655] | $14,342 - $14,574 | 232% |
| Otj Intermountain Claims Inc [666] | $14,342 - $14,574 | 232% |
| Otj Liberty Mutual Wausau Underwriters [671] | $14,342 - $14,574 | 232% |
| Otj Penser No American [663] | $14,342 - $14,574 | 232% |
| Otj Pinnacle Risk Mgmt [661] | $14,342 - $14,574 | 232% |
| Otj Saif [667] | $14,342 - $14,574 | 232% |
| Otj Sedgwick Cms [660] | $14,342 - $14,574 | 232% |
| Otj Sedgwick [668] | $14,342 - $14,574 | 232% |
| Otj Travelers Insurance [672] | $14,342 - $14,574 | 232% |
| Otj Tristar [673] | $14,342 - $14,574 | 232% |
| Bridgespan [342] | $15,861 | 257% |
| Asuris Northwest Health [202] | $18,660 | 302% |
| Healthcare Management Admin [201] | $18,660 | 302% |
| Regence Group Administrators [203] | $18,660 | 302% |