CMS Price Transparency Data

Hospital observation (per hour)

Facility: Mercy St Francis Hospital

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $76
Cash Discount Price: $56
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Mercy St Francis Hospital is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.

Cash / Self-Pay

$56

Average discount available for prompt cash payment at this facility.

Insurance Median

$76

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
Medicaid / KanCare	$5 - $87	N/A
Cigna	$22 - $87	N/A
Blue Cross Blue Shield	$22 - $455	N/A
Pace of the Ozarks Contracted [320518]	$22 - $32	N/A
Kindful Hospice Contracted [320434]	$22 - $32	N/A
Cherokee Nation Health Serv Contracted [320066]	$22 - $32	N/A
Mercy Hospice Okc [20252]	$22 - $32	N/A
Dept of Veteran Affairs Contracted [320106]	$22 - $32	N/A
Cross Timbers Hospice [20098]	$22 - $32	N/A
Humana	$22 - $83	N/A
Halo Hcr Inc Hospice [20432]	$22 - $32	N/A
Acentra Health Contracted [320527]	$22 - $25	N/A
Elara Caring Aspire Hospice [20433]	$22 - $32	N/A
Aetna	$22 - $82	N/A
Medical Associates Health Contracted [320444]	$22 - $32	N/A
Provider Partners Health Plans Contracted [320450]	$22 - $32	N/A
UnitedHealthcare	$22 - $87	N/A
Mercy Mgd Behavioral Health Contracted [320259]	$22 - $32	N/A
Medicare (plans)	$22 - $33	N/A
Halo Hcr Inc Hospice Contracted [320432]	$22 - $32	N/A
Qual Choice Contracted [320325]	$22 - $32	N/A
Indian Health Service Contracted [320198]	$22 - $32	N/A
Kindful Hospice [20434]	$22 - $32	N/A
Globalhealth Contracted [320145]	$22 - $32	N/A
Tricare	$27 - $31	N/A
Healthscope Contracted [320182]	$27 - $42	N/A
Administrative Payor Contracted [320005]	$36 - $41	N/A
Centivo Contracted [320505]	$36 - $53	N/A
Novasys Contracted [320285]	$42 - $48	N/A
Home State Health Plan Contracted [320187]	$42 - $48	N/A
Ambetter / Centene	$42 - $48	N/A
Preferred Health Plan Contracted [320522]	$52 - $60	N/A
Healthlink Contracted [320179]	$52 - $87	N/A
Workers Comp [20426]	$64 - $78	N/A
Point C Contracted [320238]	$72 - $87	N/A
Auxiant Contracted [320462]	$72 - $87	N/A
United Medical Resources Contracted [320454]	$72 - $86	N/A
Mercy Benefit Admin Contracted [320251]	$72 - $87	N/A
USA Managed Care Org Contracted [320429]	$76 - $87	N/A
Imagine 360 Contracted [320494]	$76 - $87	N/A
Benefit Management Contracted [320052]	$76 - $87	N/A
Insurance System Inc Contracted [320465]	$76 - $87	N/A
Medica Contracted [320239]	$76 - $87	N/A
Yuzu Health Contracted [320521]	$76 - $87	N/A
Multiplan Contracted [320270]	$76 - $87	N/A
90 Degree Benefits Contracted [320436]	$76 - $87	N/A
Health Systems Inc Contracted [320174]	$76 - $87	N/A
Private Health Care Systems Contracted [320320]	$76 - $87	N/A
Reflect Health Contracted [320492]	$76 - $87	N/A
Show-Me Health Administrators Contracted [320483]	$76 - $87	N/A
Edison Health Solutions Contracted [320502]	$76 - $87	N/A
Evolutions Health Care Contracted [320124]	$76 - $87	N/A
First Health Contracted [320128]	$76 - $87	N/A
Point C [20238]	$76 - $87	N/A
Ebms Contracted [320493]	$76 - $87	N/A
Aither Health Contracted [320449]	$76 - $87	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 $56.
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 Mercy St Francis 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.