CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: St Nicholas Hospital

Billing Code: 47562 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$8,234

about 1.3× the $6,176 Medicare rate · typically $5,110–$10,012

modeled estimate · not a bill or quote

What this hospital charges insurers

$7,604

About the fair price

about $630 under the fair price · 1.2× Medicare

Medicare pays $6,176 Fair price $8,234 This hospital $7,604 Cash price $14,703 Hospital's list price $22,277

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $899 Priciest $7,604

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Gallbladder removal (laparoscopic) is about $8,234 (about 1.3× the $6,176 Medicare rate). St Nicholas Hospital charges insurers about $7,604, or about $14,703 in cash — about the fair price. Located in Sheboygan, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$5,640 - $14,446	91%
Blue Cross Blue Shieldmajor	$1,471 - $15,802	24%
Aetnamajor	$5,640 - $22,277	91%
Cignamajor	$15,594	252%
Humanamajor	$5,640 - $18,935	91%
Health Net	$9,056 - $13,584	147%
Medica	$5,640	91%
Meridian	$1,471 - $2,207	24%
Molina	$1,560 - $11,138	25%
Security Health Plan	$5,696 - $14,219	92%
+ 15 smaller / regional plans	$1,471 - $22,277

Government programs also on file: Medicare, Medicaid.

Excludes 6 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 14,703), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 47562.

Insurance Before you use insurance

Call your insurance company to confirm St Nicholas Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 47562.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Nicholas Hospital

Compare: Gallbladder removal (laparoscopic) at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.