CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Cleveland Clinic Martin North Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $1,228
Cash Discount Price: $10,874
vs. Medicare Baseline: 0.20x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Cleveland Clinic Martin North Hospital is $1,228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,874. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.20x the Medicare baseline. Located in 200 Se Hospital Ave, Stuart, FL.

Cash / Self-Pay

$10,874

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,228

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: $10,874 (176%)

Insurance Median: $1,228 (20%)

Cash: $10,874 (176% of Medicare)

Ins. Median: $1,228 (20% 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
Freedom Health	$512 - $6,149	8%
Amerihealth	$528	9%
Miami Childrens Health Plan	$538 - $5,856	9%
Molina	$538	9%
Sunshine Health	$538	9%
Blue Cross Blue Shield	$588 - $10,892	10%
Independent Living Systems	$615 - $749	10%
Avmed	$714 - $22,547	12%
United	$714 - $18,801	12%
Careplus	$749 - $6,149	12%
Clear Spring Health	$771 - $871	12%
Aetna	$831 - $26,719	13%
Multiplan	$842 - $1,071	14%
Cigna	$859 - $14,933	14%
Clarity Health	$2,450 - $19,297	40%
The Legacy Companies	$2,450 - $19,297	40%
Consociate Health	$2,828	46%
Humana	$5,856	95%
Wellcare	$5,856	95%
Devoted Health	$6,442	104%
Bmi	$16,328	264%

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 $10,874.
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 Cleveland Clinic Martin North 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.