CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Penn State Health St. Joseph

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $7,009
Cash Discount Price: $9,864
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Penn State Health St. Joseph is $7,009. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,864. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 1.13x the Medicare baseline. Located in 2500 Bernville Road, Reading, PA.

Cash / Self-Pay

$9,864

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,009

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: $9,864 (160%)

Insurance Median: $7,009 (113%)

Cash: $9,864 (160% of Medicare)

Ins. Median: $7,009 (113% 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
[Amerihealth Caritas]	$5,226 - $6,149	85%
[Highmark Wholecare]	$5,226 - $6,149	85%
[Geisinger]	$5,534 - $27,358	90%
[Health Partners Plans]	$5,718 - $6,272	93%
[Pa Health & Wellness]	$5,749 - $6,333	93%
[Highmark]	$6,087 - $33,419	99%
UnitedHealthcare	$6,149 - $25,674	100%
[Cbc]	$6,149 - $20,046	100%
[Ibc]	$6,149 - $18,848	100%
Aetna	$6,210 - $19,370	101%
Humana	$6,210	101%
[Healthspring]	$6,210	101%
[Upmc]	$6,272 - $28,018	102%
[Point Comfort Underwriters]	$7,686	124%
Cigna	$23,266	377%
[Highmark Choice Blue]	$26,735	433%
[Highmark Aca]	$28,072	454%
[Preferred Healthcare Systems]	$28,442	460%
[First Health]	$30,338	491%
[Multiplan]	$30,338	491%

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 $9,864.
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 Penn State Health St. Joseph 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.