CMS Price Transparency Data

Hospital observation (per hour)

Facility: Porter Hospital Inc

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $62
Cash Discount Price: $97
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Porter Hospital Inc is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 115 Porter Drive, Middlebury, VT.

Cash / Self-Pay

$97

Average discount available for prompt cash payment at this facility.

Insurance Median

$62

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
Fidelis Care	$41	N/A
Martins Point	$46	N/A
Veterans Choice	$46	N/A
UnitedHealthcare	$46 - $96	N/A
Mvp	$46 - $72	N/A
Capital District Physicians' Health Plan	$46 - $81	N/A
Veterans Affairs Community Care Network	$46	N/A
Aetna	$46	N/A
Blue Cross Blue Shield	$47 - $76	N/A
Wellpath	$53	N/A
Harvard Pilgrim	$78	N/A
Coventry	$85	N/A
Multiplan	$92	N/A
Medical Corporation	$92	N/A
Cigna	$3,103	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 $97.
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 Porter Hospital Inc 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.