CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Adventist Health Sonora

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $616
Cash Discount Price: $61
vs. Medicare Baseline: 0.10x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Adventist Health Sonora is $616. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.10x the Medicare baseline. Located in 1000 Greenley Road, Sonora, CA.

Cash / Self-Pay

$61

Average discount available for prompt cash payment at this facility.

Insurance Median

$616

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: $61 (1%)

Insurance Median: $616 (10%)

Cash: $61 (1% of Medicare)

Ins. Median: $616 (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
Bc Mcal	$93	2%
Celtic Ca Hlth Well Mcal - All Plans	$93	2%
Central Ca Alliance Mcal	$93	2%
Healthnet Mcal	$93	2%
Medi-Cal	$93	2%
Central Ca Alliance Ccs Mcal	$140	2%
Central Ca Alliance Comm Profee Only-All Other Pla	$140	2%
Central Ca Alliance Chdp Mcal	$186	3%
UnitedHealthcare	$261 - $1,923	4%
Beech Street- All Plans	$273 - $2,008	4%
Trpn - Three Rivers Ppo - All Plans	$273 - $2,008	4%
Blue Shield Mcare	$616	10%
Central Ca Alliance Mcr Adv Profee Only	$616	10%
Healthnet Mcr Adv	$616	10%
Tricare	$616	10%
Ah Employee Health Plan - All Plans	$677	11%
Cigna	$757	12%
Greatwest Oa/Pos/Hmo	$800	13%
Greatwest Ppo - All Other Plans	$800	13%
Western Growers/Pinnacle - All Plans	$856	14%
Healthnet - All Other Plans	$897	15%
Blue Shield Epn	$999	16%
Blue Shield - All Other Plans	$1,056	17%
Aetna	$1,157	19%
Bc Mcs	$1,516	25%
Bc Non-Mcs - All Other Plans	$1,516	25%

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 $61.
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 Sonora 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.