CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Oakleaf Surgical Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 47562
  • Insurance Median: $5,988
  • Cash Discount Price: $19,663
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Oakleaf Surgical Hospital is $5,988. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,663. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.97x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$19,663

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,988

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: $19,663 (318%)
Insurance Median: $5,988 (97%)
Cash: $19,663 (318% of Medicare)
Ins. Median: $5,988 (97% 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 $5,988 - $11,874 97%
Dean Health Plan $5,988 97%
Group Health Cooperative Of Eau Claire $5,988 97%
Healthpartners $5,988 97%
Humana $5,988 97%
Medica $5,988 97%
Quartz Health Solutions $5,988 97%
Security Health Plan Of Wi $5,988 - $7,554 97%
Ucare Wi $5,988 97%
UnitedHealthcare $5,988 97%

Consumer Guidance & Cost Commentary

For the gallbladder removal (laparoscopic) procedure at Oakleaf Surgical Hospital in Altoona, Wisconsin, the cash median price is $19,663, which is significantly higher than the Medicare benchmark of $6,176.47. While the facility's gross charge is listed at $21,847, patients should be aware that commercial insurance negotiated rates often exceed the cash price due to administrative overhead and contract structures. In this specific case, the median negotiated rate is $5,988, which is lower than the cash price, meaning patients with high-deductible plans or those paying out-of-pocket might save money by paying the negotiated rate directly rather than the cash price, provided they have met their deductibles.

The hospital, which is owned by physicians and rated as an Acute Care Hospital, reports a median paid amount of $1,504, indicating that insurance companies are paying a fraction of the negotiated rate. Among the ten payers listed, most including Blue Cross Blue Shield, Dean Health Plan, and UnitedHealthcare, have a consistent low rate of $5,988, though Blue Cross Blue Shield and Security Health Plan Of Wi offer a high rate of $11,874 and $7,554 respectively. Patients are encouraged to verify their specific plan details before scheduling, as assuming in-network status guarantees the lowest possible price can be misleading. Additionally, patients should contact the hospital directly to inquire about self-pay or prompt-pay discounts, which could further reduce the final cost if they choose to pay upfront.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals