CMS Price Transparency Data

Hospital observation (per hour)

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $506
Cash Discount Price: $445
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at UPMC Children's Hospital of Pittsburgh is $506. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $445. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$445

Average discount available for prompt cash payment at this facility.

Insurance Median

$506

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
Aetna	$54 - $3,024	N/A
UnitedHealthcare	$87 - $3,055	N/A
Blue Cross Blue Shield	$92 - $632	N/A
Geisinger	$98 - $3,505	N/A
Cigna	$102 - $696	N/A
UPMC Health Plan	$136 - $4,612	N/A
Intergroup	$141 - $1,075	N/A
Health Plan of Upper Ohio Valley	$141 - $822	N/A
Saudi Armed Forces	$174 - $1,012	N/A
Coventry/First Health	$174 - $1,012	N/A
Health Payors Organization	$184 - $1,075	N/A
Multiplan	$184 - $1,075	N/A
National Provider Network	$195 - $1,138	N/A
Private Health Care Systems	$195 - $1,138	N/A
Amerihealth Caritas	$2,882	N/A
PA Health & Wellness	$3,117	N/A
Health Partners Plans (Jefferson Health Plan)	$3,278	N/A
Highmark Wholecare (Prev Gateway)	$3,420	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 $445.
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 UPMC Children's Hospital of Pittsburgh 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.