CMS Price Transparency Data

Hospital observation (per hour)

Facility: Children's Hospital of Philadelphia

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $462
Cash Discount Price: $880
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Children's Hospital of Philadelphia is $462. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $880. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$880

Average discount available for prompt cash payment at this facility.

Insurance Median

$462

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
UnitedHealthcare	$146 - $484	N/A
Aetna	$232 - $440	N/A
UPMC Medical Assistance	$240	N/A
Keystone Health Plan East	$278	N/A
Blue Cross Blue Shield	$311 - $352	N/A
Geisinger Health Plan Commercial	$387	N/A
Jefferson Health Plans	$416	N/A
Cigna	$440	N/A
Highmark	$440	N/A
Qualcare	$484	N/A
First Health Network	$572	N/A
Private Health Care Systems	$704	N/A
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$704	N/A
Choice Care Network	$792	N/A
Horizon Nj Health	$880	N/A
Geisinger Medical Assistance	$1,318	N/A
Highmark Wholecare	$2,787	N/A
Health Partners	$2,831	N/A
Medicaid / KanCare	$4,172	N/A
Keystone First Chip	$7,927	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 $880.
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 Children's Hospital of Philadelphia 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.