CMS Price Transparency Data

Hospital observation (per hour)

Facility: Bertrand Chaffee Hospital

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $1,001
Cash Discount Price: $149
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Bertrand Chaffee Hospital is $1,001. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $149. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 224 East Main Street, Springville, NY.

Cash / Self-Pay

$149

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,001

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
Private Pay	$149	N/A
Guardian Life Ins. Co.	$175	N/A
No-Fault	$175	N/A
Mvp Commercial	$175	N/A
American Progressive Ins.	$175	N/A
Cigna	$175	N/A
Aetna	$175	N/A
No Amer Meritian Health	$175	N/A
Global Excel Mgt	$175	N/A
Commercial / Misc	$175	N/A
Iha Essential Plans	$1,826	N/A
Iha Medisource	$1,826	N/A
Iha	$1,869	N/A
Iha Custom Coverage	$1,869	N/A
Iha Encompass 65	$1,930	N/A
Blue Cross Blue Shield	$2,279 - $2,849	N/A
Senior Blue - Bc	$2,440	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 $149.
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 Bertrand Chaffee 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.