CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Adventist Health St Helena

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $874
Cash Discount Price: $366
vs. Medicare Baseline: 0.14x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Adventist Health St Helena is $874. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $366. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.14x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$366

Average discount available for prompt cash payment at this facility.

Insurance Median

$874

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: $366 (6%)

Insurance Median: $874 (14%)

Cash: $366 (6% of Medicare)

Ins. Median: $874 (14% 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
Medi-Cal	$93	2%
Blue Shield Bh Mcr Adv	$674	11%
Blue Shield Mcr Adv	$674	11%
Kaiser Mcr Adv	$674	11%
Tricare	$674	11%
Ah Employee Health Plan - All Plans	$741	12%
Cigna	$799	13%
Interplan-All Plans	$808	13%
Kaiser-All Other Plans	$808	13%
UnitedHealthcare	$874	14%
Western Growers-All Plans	$963	16%
Aetna	$1,040	17%
Blue Shield Epn-All Other Plans	$1,076	17%
Blue Shield Non-Epn	$1,137	18%
Phcs-All Plans	$1,343	22%
Blue Cross Blue Shield	$1,799	29%
Health Management Network-All Plans	$2,076	34%
Three Rivers-All Plans	$2,198	36%

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 $366.
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 Adventist Health St Helena 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.