CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Fort Memorial Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $5,623
Cash Discount Price: $4,940
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Fort Memorial Hospital is $5,623. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,940. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.91x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.

Cash / Self-Pay

$4,940

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,623

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: $4,940 (80%)

Insurance Median: $5,623 (91%)

Cash: $4,940 (80% of Medicare)

Ins. Median: $5,623 (91% 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
Molina	$626 - $5,623	10%
UnitedHealthcare	$766 - $5,623	12%
Blue Cross Blue Shield	$1,504 - $6,278	24%
Dean Health Plan	$1,504 - $13,610	24%
Medicaid / KanCare	$1,504	24%
Quartz	$1,504 - $6,208	24%
Managed Health Services	$1,640	27%
Group Health Cooperative	$1,675 - $9,880	27%
Fort Care	$2,015	33%
Humana	$5,623 - $8,014	91%
Medicare (plans)	$5,623	91%
Aetna	$6,160 - $11,455	100%
Veteran Evaluation Services	$6,677	108%
Alliance	$10,961	177%
Mercycare	$11,372	184%
Centivo	$12,821 - $13,355	208%
Trilogy	$13,431	217%
Cigna	$14,512	235%

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 $4,940.
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 Fort Memorial Hospital 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.