CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Roxborough Memorial Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $6,490
Cash Discount Price: $6,180
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Roxborough Memorial Hospital is $6,490. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,180. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 1.05x the Medicare baseline. Located in 5800 Ridge Ave, Philadelphia, PA.

Cash / Self-Pay

$6,180

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,490

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: $6,180 (100%)

Insurance Median: $6,490 (105%)

Cash: $6,180 (100% of Medicare)

Ins. Median: $6,490 (105% 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
Medicaid / KanCare	$776	13%
Health Partners Plan	$1,582 - $9,271	26%
UnitedHealthcare	$2,040 - $12,918	33%
Pa Health & Wellness	$3,500 - $7,417	57%
Keystone	$3,634 - $6,428	59%
Humana	$4,944	80%
Blue Cross Blue Shield	$6,180 - $8,758	100%
Medicare (plans)	$6,180 - $6,490	100%
Tricare	$6,180	100%
Providers Partner Health Plan	$6,366	103%
Spartan	$6,490	105%
Auto Insurance	$6,799	110%
Worker Compensation	$6,984	113%
Employer Direct Healthcare	$8,653	140%
Naphcare	$9,580	155%
Cigna	$11,256 - $14,617	182%
Highmark	$11,256 - $13,467	182%

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 $6,180.
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 Roxborough Memorial Hospital 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.