CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Tomah Memorial Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $618
Cash Discount Price: $1,477
vs. Medicare Baseline: 0.10x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Tomah Memorial Hospital is $618. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,477. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.10x the Medicare baseline. Located in 501 Gopher Dr, Tomah, WI.

Cash / Self-Pay

$1,477

Average discount available for prompt cash payment at this facility.

Insurance Median

$618

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: $1,477 (24%)

Insurance Median: $618 (10%)

Cash: $1,477 (24% of Medicare)

Ins. Median: $618 (10% 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
Blue Cross Blue Shield	$124 - $1,437	2%
Managed Hlth Mcaid - All Plans	$124	2%
Security Hp Mcaid	$124	2%
UnitedHealthcare	$478 - $1,619	8%
Group Hlth Mcr Adv - All Plans	$562	9%
Independent Care Mcr - All Other Plans	$562	9%
Quartz Mcr Adv	$562	9%
Security Hp Mcr Adv	$562	9%
Va Ccn - All Plans	$562	9%
Independent Care Mcaid	$618	10%
Quartz Mcaid	$618	10%
Aetna	$646 - $2,183	10%
Security Hp Comm - All Other Plans	$2,183	35%
Quartz Comm - All Other Plans	$2,312	37%
Humana	$2,376	38%
The Alliance - All Plans	$2,387	39%
Cigna	$2,492	40%

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 $1,477.
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 Tomah 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.