CMS Price Transparency Data

Gallbladder removal (laparoscopic)

Facility: Kenmore Mercy Hospital

Billing Code: 47562 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 47562
Insurance Median: $334
Cash Discount Price: $1,863
vs. Medicare Baseline: 0.05x Medicare

The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Kenmore Mercy Hospital is $334. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,863. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.05x the Medicare baseline. Located in 2950 Elmwood Avenue, Kenmore, NY.

Cash / Self-Pay

$1,863

Average discount available for prompt cash payment at this facility.

Insurance Median

$334

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: $1,863 (30%)

Insurance Median: $334 (5%)

Cash: $1,863 (30% of Medicare)

Ins. Median: $334 (5% 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
UnitedHealthcare	$70 - $718	1%
Cigna	$85 - $911	1%
Tricare	$85 - $628	1%
Medicare (plans)	$85 - $691	1%
Hospice [550001]	$85 - $628	1%
Champ VA [700002]	$85 - $628	1%
Covid19 Hrsa [45013]	$85 - $628	1%
Fallon Health [450115]	$85 - $628	1%
VA Veterans Affairs [700001]	$85 - $565	1%
Seneca Nation [450119]	$85 - $628	1%
Univera Healthcare Essential [100170]	$87 - $541	1%
Univera Healthcare [100169]	$87 - $795	1%
Blue Cross Blue Shield	$94 - $769	2%
Medicaid / KanCare	$284 - $628	5%
Independent Health Essential [100166]	$284 - $334	5%
Crime Victims [100176]	$334	5%
Vna Option Mltc [350110]	$334	5%
Tuscarora Nation [550120]	$334	5%
Excellus Rochester McD [350117]	$334	5%
Amerigroup [350102]	$334	5%
Beacon Essential [350122]	$534 - $754	9%
Beacon Health Options [100023]	$534 - $754	9%
Humana	$565 - $659	9%
Wellcare [450129]	$587 - $691	10%
Fidelis Essential [100163]	$590 - $691	10%
Catholic Health Life Pace [400005]	$628	10%
Independent Health [100165]	$638 - $751	10%
Iha First Choice [800001]	$638 - $751	10%
Aetna	$659	11%
Wellcare Fidelis Dual [450451]	$659	11%
Fidelis Dual Advantage [450120]	$659	11%
Mvp Healthcare [100168]	$689 - $811	11%
Ghi [100153]	$691	11%
Molina Essential [100167]	$751	12%
Fidelis Exchange [100164]	$754	12%
UPMC Health Plan [100181]	$1,130	18%
No Fault [114001]	$1,774	29%
Federal Workers Compensation [500100]	$1,774	29%

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 $1,863.
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 Kenmore Mercy 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.