CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Modoc Medical Center

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $2,604
Cash Discount Price: $2,809
vs. Medicare Baseline: 0.42x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Modoc Medical Center is $2,604. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,809. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.42x the Medicare baseline. Located in 1111 N Nagle Street, Alturas, CA.

Cash / Self-Pay

$2,809

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,604

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: $2,809 (45%)

Insurance Median: $2,604 (42%)

Cash: $2,809 (45% of Medicare)

Ins. Median: $2,604 (42% 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
Adv Med Mgmt - All Plans	$669	11%
Medi-Cal	$669	11%
Medi-Cal 7/1/24	$669	11%
Blue Shield Mcr Adv	$1,521	25%
Blue Shield Va	$1,521	25%
UnitedHealthcare	$1,521 - $2,669	25%
Tricare	$1,601	26%
Healthnet Mcr Adv	$1,617	26%
Blue Shield Comm - All Other Plans	$1,800	29%
Blue Shield Exch	$2,309	37%
Blue Cross Blue Shield	$2,310 - $2,566	37%
Partnership Hp - All Plans	$2,340	38%
Carelon - All Plans	$2,566	42%
Corvel - All Plans	$2,641	43%
Aetna	$2,669	43%
Coventry/First Health - All Plans	$2,669	43%
Galaxy Health - All Plans	$2,669	43%
Healthnet Comm - All Other Plans	$2,669	43%
Hmn - All Plans	$2,669	43%
Integrated Hp - All Other Plans	$2,669	43%
Interplan - All Plans	$2,669	43%
Multiplan - All Other Plans	$2,669	43%
Superior Ca Ppo - All Plans	$2,669	43%
Multiplan Wc	$5,868	95%
Ntwrks By Design Wc - All Plans	$6,115	99%
Integrated Hp Wc	$6,176	100%

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 $2,809.
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 Modoc Medical Center 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.