CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $7,335
Cash Discount Price: $21,055
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at UMass Memorial Health - Harrington Hospital is $7,335. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21,055. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 1.19x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$21,055

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,335

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: $21,055 (341%)

Insurance Median: $7,335 (119%)

Cash: $21,055 (341% of Medicare)

Ins. Median: $7,335 (119% 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
Hsno/Free Care [10801]	$681	11%
Fallon Connectorcare [10503]	$714	12%
Harvard Pilgrim [10701]	$4,001	65%
Wellpoint [11112]	$4,794	78%
Blue Cross Blue Shield	$5,256 - $7,578	85%
Champva [11001]	$6,929	112%
Cigna	$7,335	119%
Institution [10406]	$7,335	119%
Mgb Mcr [10124]	$7,335	119%
Tufts Us Family [11203]	$7,335	119%
Aetna	$7,702	125%
Commonwealth Care Alliance [10103]	$7,702	125%
Fallon Mcr Supp [20202]	$7,702	125%
Fallon Mcr [10105]	$7,702	125%
Tufts Mcr [10112]	$7,702	125%
UnitedHealthcare	$7,702 - $7,848	125%
Senior Whole Health [10110]	$7,848	127%
Tufts Connectorcare [10507]	$12,477	202%

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 $21,055.
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 UMass Memorial Health - Harrington 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.