CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Avita Ontario

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 47562
  • Insurance Median: $6,176
  • Cash Discount Price: $36,778
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Avita Ontario is $6,176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36,778. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 1.00x the Medicare baseline. Located in 715 Richland Mall, Ontario, OH.
Cash / Self-Pay
$36,778

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,176

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: $36,778 (595%)
Insurance Median: $6,176 (100%)
Cash: $36,778 (595% of Medicare)
Ins. Median: $6,176 (100% 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.

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
Amerihealth $1,000 16%
Blue Cross Blue Shield $1,000 - $30,850 16%
Buckeye $1,000 - $6,176 16%
Caresource $1,000 16%
Humana $1,000 - $6,176 16%
Medicaid / KanCare $1,000 16%
Molina $1,000 - $6,176 16%
United_Healthcare $1,000 - $31,261 16%
Aetna $6,176 - $43,268 100%
Medical_Mutual $6,176 - $34,615 100%
Medicare (plans) $6,176 100%
Mount_Carmel $6,176 100%
Cigna $33,706 546%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 715 Richland Mall, Ontario, OH 44906
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals