CMS Price Transparency Data

Hospital observation (per hour)

Facility: Holy Cross Hospital-Davis

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $40
Cash Discount Price: $28
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Holy Cross Hospital-Davis is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1600 West Antelope Drive, Layton, UT.

Cash / Self-Pay

$28

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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
Cigna	$25 - $56	N/A
Blue Cross Blue Shield	$26 - $42	N/A
Molina	$30	N/A
Pehp	$30 - $40	N/A
Aetna	$31 - $59	N/A
Uuhp	$34 - $38	N/A
Select Health	$34	N/A
Wise	$36 - $37	N/A
Deseret Mutual Benefit Administrators	$43	N/A
Multiplan	$48 - $63	N/A
UnitedHealthcare	$50 - $69	N/A
Emi Health	$60	N/A
Centura Employee Plan	$1,865	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 $28.
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 Holy Cross Hospital-Davis 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.