CMS Price Transparency Data

Hospital observation (per hour)

Facility: St Francis Hospital & Medical Center

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $9,995
Cash Discount Price: $4,428
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at St Francis Hospital & Medical Center is $9,995. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,428. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 114 Woodland Street & 500 Blue Hills Avenue, Hartford, CT.

Cash / Self-Pay

$4,428

Average discount available for prompt cash payment at this facility.

Insurance Median

$9,995

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
Health New England	$177	N/A
Paramount HMO	$218	N/A
Manhattan Life	$218	N/A
Pai	$218	N/A
Christian Care Ministry	$218	N/A
Trinity Health Share	$218	N/A
Allied National Global Care	$218	N/A
Mvp	$218	N/A
Pan-American Life	$218	N/A
Lifetime Benefit Solutions	$218	N/A
Asrm - Reliance Standard Life Insurance	$218	N/A
Family Life Insurance Company	$218	N/A
Medi Share	$218	N/A
PHCS	$218	N/A
International Benefit Administrators	$218	N/A
Dean Health	$218	N/A
Multiplan	$218	N/A
Ghc Scw	$218	N/A
Prime Health Services	$225	N/A
Cigna	$257 - $10,460	N/A
Health Smart	$273	N/A
Connecticut Dept of Correction	$2,896	N/A
Medicare (plans)	$3,073 - $3,230	N/A
Aetna	$3,073 - $9,995	N/A
Blue Cross Blue Shield	$3,073 - $10,897	N/A
UnitedHealthcare	$3,134 - $12,660	N/A
Cca Senior Care Options	$3,134	N/A
Fallon Health	$4,076	N/A
Innovative Health Plan II	$6,585	N/A
Connecticare	$9,170 - $11,210	N/A
Hap	$9,995	N/A
1199 National Benefit Fund	$9,995	N/A
Webtpa	$9,995	N/A
Meritain	$9,995	N/A
Nippon Life Ins	$9,995	N/A
Luminare Health	$9,995	N/A
Allied Benefit Systems	$9,995	N/A
Gravie Admin Services	$9,995	N/A
Allegiance	$10,460	N/A
Health Partners	$10,460	N/A
Magnacare	$10,460	N/A
Blue Shield - Ca	$10,897	N/A
Pre-Employment	$10,897	N/A
Kaiser Domestic	$10,897	N/A
Unicare	$10,897	N/A
Blue Distinction Transplant	$10,897	N/A
Blue Shield - Ny Highmark Western	$10,897	N/A
Blue Benefit Administrators of Massachusetts	$10,897	N/A
Bcn Domestic	$10,897	N/A
Wc Domestic	$10,897	N/A
Blue Shield - PA (Highmark)	$10,897	N/A
Health Choices	$10,897	N/A
Wellpoint	$10,897	N/A
Blue Shield - Ny Highmark Northeastern	$10,897	N/A
Blue Care Network	$10,897	N/A
Blue Shield - Wa (Regence)	$10,897	N/A
Blue Shield - Id (Regence)	$10,897	N/A
Geha	$12,660	N/A
Harvard Pilgrim Healthcare	$12,660	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 $4,428.
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 St Francis Hospital & Medical Center 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.