CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: St Nicholas Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 47562
  • Insurance Median: $11,406
  • Cash Discount Price: $14,703
  • vs. Medicare Baseline: 1.85x Medicare
The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at St Nicholas Hospital is $11,406. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,703. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 1.85x the Medicare baseline. Located in 3100 Superior Ave, Sheboygan, WI.
Cash / Self-Pay
$14,703

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,406

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: $14,703 (238%)
Insurance Median: $11,406 (185%)
Cash: $14,703 (238% of Medicare)
Ins. Median: $11,406 (185% 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.

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
Blue Cross Blue Shield $1,471 - $15,802 24%
Community Care Family Care $1,471 - $2,207 24%
Managed Health Services $1,471 - $2,207 24%
Medicaid / KanCare $1,471 - $2,207 24%
Meridian Health Plan $1,471 - $2,207 24%
Molina Healthcare $1,560 - $5,640 25%
Triology $1,560 - $17,599 25%
Aetna $5,640 - $22,277 91%
Humana $5,640 - $18,935 91%
Medica $5,640 91%
Medicare (plans) $5,640 91%
UnitedHealthcare $5,640 - $14,446 91%
Security Health Plan $5,696 - $14,219 92%
P360 Small Group $9,056 - $13,584 147%
Prevea Health Network $9,056 - $13,584 147%
Molina Healthcare Of Wi $11,138 180%
Hshs Employees $12,074 195%
Naphcare $12,689 205%
Arise Health Plan $13,366 216%
Wea Provider Network $13,812 - $16,039 224%
Cigna $15,594 252%
Interplan $15,594 252%
Network Health Plan $15,594 252%
Health Care Alliance $16,262 263%
Health Eos $16,708 271%
Healthsmart $16,708 271%
Wisconsin Physician Service $17,821 289%
Multiplan/Phcs $18,712 303%
Choicecare $18,935 307%
North Central Healthcare Alliance $20,495 332%
First Health $21,163 343%
Caterpillar, Inc. $22,277 361%
Cofinity $22,277 361%
Live360 $22,277 361%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Superior Ave, Sheboygan, WI 53081
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals