CMS Price Transparency Data

Hospital observation (per hour)

Facility: Boston Children's Hospital

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $432
Cash Discount Price: $802
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Boston Children's Hospital is $432. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $802. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$802

Average discount available for prompt cash payment at this facility.

Insurance Median

$432

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

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
Cdphp	$84 - $1,218	N/A
Harvard Pilgrim	$87 - $968	N/A
Blue Cross Blue Shield	$96 - $946	N/A
United	$102 - $1,197	N/A
Aetna	$103 - $1,201	N/A
Mgb/Allways	$104 - $1,059	N/A
Tufts Public Plan	$105 - $882	N/A
United Ri Nj Ny	$108 - $903	N/A
Ambetter / Centene	$108 - $906	N/A
Carelon Strategies/Bhs	$111 - $931	N/A
UnitedHealthcare	$111 - $1,218	N/A
Carelon/Beacon	$128 - $1,075	N/A
Fallon	$130 - $1,105	N/A
Health New England	$138 - $1,158	N/A
Interlink Transplant	$145 - $1,218	N/A
Cigna	$145 - $1,293	N/A
Ets/Lifetrac	$145 - $1,218	N/A
Humana	$154 - $1,290	N/A
Community Health Options	$154 - $1,290	N/A
Multiplan/Phcs	$157 - $1,361	N/A
Coventry/Hcvm/First Health	$157 - $1,318	N/A

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 $802.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0378.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Boston Children's Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0378.
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.