CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Garnet Health Medical Center

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $5,528
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Garnet Health Medical Center is $5,528. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.90x the Medicare baseline. Located in 707 East Main Street, Middletown, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,528

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%)

Insurance Median: $5,528 (90%)

Ins. Median: $5,528 (90% 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
Magnacare	$1,910 - $3,056	31%
Aetna	$2,842 - $7,547	46%
Local 1199	$2,842 - $4,262	46%
Mvp	$3,349	54%
Emblem Health	$3,468	56%
UnitedHealthcare	$4,862	79%
Cigna	$6,194	100%
Cdphp	$6,647	108%
Blue Cross Blue Shield	$7,510 - $7,707	122%
Fidelis	$7,697	125%
Wellcare	$7,720	125%
Rojw	$13,206	214%
Northwell Direct	$15,470	250%
Geisinger Health Plan	$18,866	305%

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 $X.
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 Garnet Health 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.