CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Harlem Hospital Center

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $4,528
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.73x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Harlem Hospital Center is $4,528. 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 0.73x the Medicare baseline. Located in 506 Lenox Avenue, New York, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,528

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: $4,528 (73%)

Ins. Median: $4,528 (73% 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
Emblem	$319 - $10,356	5%
Magnacare	$320 - $12,247	5%
Oxford	$362 - $4,894	6%
United	$434 - $5,218	7%
Healthfirst	$611 - $7,255	10%
Oscar	$614 - $4,454	10%
Local 1199	$719 - $5,204	12%
Aetna	$781 - $5,402	13%
Wellcare	$825	13%
Fidelis	$1,100 - $9,804	18%
Metroplus	$1,200 - $7,255	19%
Amidacare	$3,225	52%
Blue Cross Blue Shield	$3,225 - $13,064	52%
Carelon	$3,225 - $10,614	52%
Senior Whole Health	$3,225	52%
United Behavioral Health	$3,225 - $3,547	52%
Affinity	$3,289 - $7,255	53%
Carelon (Amida Care)	$3,289	53%
Vnsny	$3,289 - $6,904	53%
Cigna	$5,356	87%
Elderplan	$6,904	112%
Vaccn	$6,904	112%
Centers Plan For Healthy Living	$7,180	116%
Centerlight	$8,165	132%
Multiplan	$13,064	212%
Villagecare Max	$13,880	225%

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 Harlem Hospital 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.