CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Pacifica Hospital of the Valley

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $5,482
Cash Discount Price: $25,236
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Pacifica Hospital of the Valley is $5,482. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,236. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.89x the Medicare baseline. Located in 9449 San Fernando Rd, Sun Valley, CA.

Cash / Self-Pay

$25,236

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,482

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: $25,236 (409%)

Insurance Median: $5,482 (89%)

Cash: $25,236 (409% of Medicare)

Ins. Median: $5,482 (89% 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
Alignment Health	$4,278	69%
America Cash Health Plan	$5,348	87%
Blue Cross Blue Shield	$5,348 - $25,236	87%
Care 1St Health Plan	$5,348	87%
Humana	$5,348	87%
La Health Care	$5,348	87%
Bright Health Group	$5,615	91%
Health Net Of California	$6,685	108%
Aetna	$12,618	204%
Altamed	$25,236	409%
Heritage Provider Network	$25,236	409%
Molina	$25,236	409%

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 $25,236.
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 Pacifica Hospital of the Valley 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.