CMS Price Transparency Data

Hospital observation (per hour)

Facility: Physicians Care Surgical Hospital

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $18,753
Cash Discount Price: $10,218
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Physicians Care Surgical Hospital is $18,753. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,218. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 454 Enterprise Drive, Royersford, PA.

Cash / Self-Pay

$10,218

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,753

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
Coventry	$15 - $23,230	N/A
Marpai Health	$15 - $23,230	N/A
Geha	$15 - $23,230	N/A
Meritain Health	$15 - $23,230	N/A
Aetna	$15 - $23,230	N/A
Ag Administrators	$15 - $23,230	N/A
Premier Care Network	$15 - $23,230	N/A
Allied Benefit Systems	$15 - $23,230	N/A
Allied Benefits Systems	$15 - $23,230	N/A
Trustmark	$15 - $23,230	N/A
Healthez	$15 - $23,230	N/A
Lucent Health	$15 - $23,230	N/A
Ag Administrators Inc	$15 - $23,230	N/A
Continental Benefits	$15 - $23,230	N/A
Keystone First	$2,850	N/A
Straight Access	$2,850	N/A
Medicaid / KanCare	$2,850	N/A
PA Health and Wellness	$2,850	N/A
Keystone First Healthplan	$2,850	N/A
Keystone First Vip Choice	$2,850	N/A
Medicare (plans)	$12,363 - $12,772	N/A
Ibc Security 65	$12,363	N/A
Personal Choice 65	$12,363	N/A
Cigna	$12,772 - $18,977	N/A
Unified Health Services	$12,772	N/A
Devon Health Services	$12,772	N/A
Vibra Health Plan	$12,772	N/A
Pcsh Aarp	$12,772	N/A
UnitedHealthcare	$12,772 - $27,099	N/A
Gpm Health and Life Insurance Mc Supplement	$12,772	N/A
Shenandoah Life	$12,772	N/A
Humana	$12,772	N/A
Tricare	$12,772	N/A
Blue Cross Blue Shield	$12,772 - $23,941	N/A
Aarp	$12,772	N/A
Keystone 65 HMO	$12,772	N/A
Amerihealth New Jersey HMO	$18,753	N/A
Carefirst Administrators	$18,753	N/A
Amerihealth Administrators	$18,753	N/A
Pcsh Ibc	$18,753	N/A
Regence Blue Shield	$18,753	N/A
Keystone HMO	$18,753	N/A
Independence Bc	$18,753	N/A
Ibc	$18,753	N/A
Independence Federal	$18,753	N/A
Ibc 2021	$18,753	N/A
Empire Plan	$18,753	N/A
Ibc - Local	$18,753	N/A
Ibc Local	$18,753	N/A
Personal Choice	$18,753	N/A
Keystone Direct POS	$18,753	N/A
Horizon of New Jersey	$18,753	N/A
Keystone Healthplan East	$18,753	N/A
Independence Administrators	$18,753	N/A
Healthgram	$18,977	N/A
Loomis	$18,977	N/A
Health Partners	$18,977	N/A
Freedom Life Insurance Company	$18,977	N/A
Sana Benefits	$18,977	N/A
Apwu	$18,977	N/A
Nalc Health	$18,977	N/A
Cwi Benefits	$18,977	N/A
UPMC	$19,295	N/A
Connecticare	$19,575	N/A
Central PA Teamsters	$21,231	N/A
Highmark	$23,941	N/A
Oxford Life Insurance Company	$27,099	N/A
Oxford Health Plan	$27,099	N/A
Golden Rule Op	$27,099	N/A
Surest	$27,099	N/A
Allsavers	$27,099	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 $10,218.
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 Physicians Care 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.