CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Tops Surgical Specialty Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $3,803
Cash Discount Price: $2,498
vs. Medicare Baseline: 0.62x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Tops Surgical Specialty Hospital is $3,803. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,498. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.62x the Medicare baseline. Located in 17080 Red Oak Drive, Houston, TX.

Cash / Self-Pay

$2,498

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,803

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: $2,498 (40%)

Insurance Median: $3,803 (62%)

Cash: $2,498 (40% of Medicare)

Ins. Median: $3,803 (62% 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
Oscar Health Plan	$839 - $3,824	14%
Ambetter / Centene	$960 - $4,848	16%
Health Net	$1,112 - $6,066	18%
UnitedHealthcare	$1,146 - $11,664	19%
Aetna	$2,102 - $8,722	34%
Blue Cross Blue Shield	$3,212 - $3,783	52%
Humana	$3,454 - $8,027	56%
Cigna	$5,137 - $8,362	83%

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 $2,498.
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 Tops Surgical Specialty 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.