CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: UPMC Pinnacle Hospitals

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $5,682
Cash Discount Price: $2,270
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at UPMC Pinnacle Hospitals is $5,682. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,270. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.92x the Medicare baseline. Located in 409 South Second Street, Harrisburg, PA.

Cash / Self-Pay

$2,270

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,682

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: $2,270 (37%)

Insurance Median: $5,682 (92%)

Cash: $2,270 (37% of Medicare)

Ins. Median: $5,682 (92% 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
Blue Cross Blue Shield	$757 - $9,756	12%
Keystone Health Plan	$757 - $9,756	12%
Prime Net	$916 - $10,390	15%
UnitedHealthcare	$1,017 - $6,141	16%
Upmc Work Partners	$1,480	24%
Geisinger	$2,081 - $7,599	34%
Intergroup	$2,460 - $11,744	40%
Wellspan Population Health	$3,216 - $11,744	52%
Aetna	$4,935 - $6,409	80%
Upmc Health Plan	$5,150	83%
Humana	$5,911	96%
Cigna	$6,026	98%
Pa Health & Wellness	$6,198	100%

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 $2,270.
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 UPMC Pinnacle Hospitals 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.