CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Clarion Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 47562
  • Insurance Median: $5,893
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Clarion Hospital is $5,893. 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 0.95x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,893

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: $5,893 (95%)
Ins. Median: $5,893 (95% 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
Upmc $737 - $6,230 12%
Workers Comp $1,471 24%
Highmark $5,557 - $9,312 90%
Highmark Community Blue $5,590 91%
Amerihealth $5,613 91%
Cigna $5,613 91%
Martin'S Point - Usfhp $5,613 91%
Medicare (plans) $5,613 91%
Tricare $5,613 91%
UnitedHealthcare $5,613 91%
Aetna $5,781 - $12,909 94%
Geisinger $5,893 95%
Devoted Health Plan $5,950 96%
The Health Plan $5,950 - $13,190 96%
Gateway $6,006 97%
Pa Health & Wellness $6,006 97%
American Health Plan $6,174 100%
Highmark - Ind.& Managed Care $12,603 204%
Peak Health $13,190 214%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals