CMS Price Transparency Data

Hospital observation (per hour)

Facility: Ohio Valley Surgical Hospital

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $12,429
Cash Discount Price: $42
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Ohio Valley Surgical Hospital is $12,429. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. 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 Main Street, Springfield, OH.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,429

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 (%)

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$2 - $42,140	N/A
Mmo Cin. HMO	$32 - $44	N/A
Mmoh (Supermed)	$32 - $33	N/A
Mmoh	$32 - $12,429	N/A
Medicare (plans)	$42 - $12,826	N/A
Preferred Health	$63	N/A
Ohio Health	$63	N/A
Luminare Health	$63	N/A
Medben	$63	N/A
Nippon Life	$72 - $21,852	N/A
Meritain	$72 - $21,852	N/A
Personify Health	$72 - $21,852	N/A
Aetna	$72 - $21,852	N/A
Mhbp	$72 - $21,852	N/A
Pacific Source	$72 - $21,852	N/A
Meritain Heatlh	$72 - $21,852	N/A
Ngs Coresource	$72 - $21,852	N/A
Mail Handlers	$72 - $21,852	N/A
Genworth	$72 - $21,852	N/A
Geha	$72 - $21,852	N/A
Medicaid / KanCare	$4,764 - $18,644	N/A
Amerihealth Caritas of Ohio	$4,898	N/A
Buckeye Community Health Plan	$4,902	N/A
UnitedHealthcare	$4,902 - $18,374	N/A
Molina McD	$4,978	N/A
Caresource	$5,319 - $18,644	N/A
Humana	$5,476 - $12,464	N/A
Molina McR+McD	$12,429	N/A
Champus	$12,429	N/A
Aarp	$12,429	N/A
Self Pay Imaging	$12,429	N/A
Medigold	$12,429	N/A
American Retirement	$12,429	N/A
American Republic	$12,429	N/A
Molina Marketplace	$12,429	N/A
Patient No Pay	$12,429	N/A
Molina	$12,429	N/A
American Continental Life	$12,429	N/A
Wellcare By Allwell	$12,429	N/A
Central States	$12,429	N/A
Everest	$12,429	N/A
Molina McR McD	$12,429	N/A
American Continental Insurance	$12,429	N/A
Molina McR	$12,429	N/A
Cigna	$12,429 - $19,686	N/A
Gateway Health Plan	$12,429	N/A
Molina Dual McR	$12,429	N/A
Bankers Fidelity	$12,429	N/A
Aarp Supplemental	$12,429	N/A
Aultcare Primetime Health Plan	$12,429	N/A
Prosperity Supplement	$12,429	N/A
Molina Dual McR	$12,429	N/A
Communicare Advantage	$12,429	N/A
Bankers Life and Casualty	$12,429	N/A
Wraparound Pl Supp	$12,429	N/A
The Health Plan	$13,051	N/A
Devoted Health	$14,334	N/A
Employer Direct	$16,109	N/A
Medica	$18,374	N/A
Ushealth	$18,374	N/A
Surest	$18,374	N/A
Golden Rule	$18,374	N/A
Oxford	$18,374	N/A
Shl	$18,374	N/A
Caresourse	$18,644	N/A
Nalc	$19,686	N/A
Healthgram	$19,686	N/A
Samba	$19,686	N/A
Unified Group	$19,686	N/A
Sbma	$19,686	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 $42.
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 Ohio Valley Surgical 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.