CMS Price Transparency Data

Hospital observation (per hour)

Facility: Johnson Memorial Hospital

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $4,730
Cash Discount Price: $67
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Johnson Memorial Hospital is $4,730. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 201 Chestnut Hill Road, Stafford Springs, CT.

Cash / Self-Pay

$67

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,730

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	$79	N/A
Cigna	$95 - $12,427	N/A
Prime Health Services	$98	N/A
Connecticare	$100 - $111	N/A
Asrm - Reliance Standard Life Insurance	$101	N/A
Dean Health	$101	N/A
Christian Care Ministry	$101	N/A
Mvp	$101	N/A
PHCS	$101	N/A
Pan-American Life	$101	N/A
Allied National Global Care	$101	N/A
Manhattan Life	$101	N/A
Pai	$101	N/A
Ghc Scw	$101	N/A
Trinity Health Share	$101	N/A
Paramount HMO	$101	N/A
Family Life Insurance Company	$101	N/A
International Benefit Administrators	$101	N/A
Multiplan	$101	N/A
Lifetime Benefit Solutions	$101	N/A
Medi Share	$101	N/A
Health Smart	$104	N/A
UnitedHealthcare	$1,137 - $8,677	N/A
United Behavioral Health Eap	$1,137	N/A
Aetna	$3,784 - $4,730	N/A
Hap	$4,730	N/A
Allied Benefit Systems	$4,730	N/A
Luminare Health	$4,730	N/A
Gravie Admin Services	$4,730	N/A
Nippon Life Ins	$4,730	N/A
Webtpa	$4,730	N/A
1199 National Benefit Fund	$4,730	N/A
Meritain	$4,730	N/A
Blue Cross Blue Shield	$5,316 - $6,860	N/A
Blue Shield - PA (Highmark)	$6,860	N/A
Wc Domestic	$6,860	N/A
Blue Shield - Ny Highmark Northeastern	$6,860	N/A
Pre-Employment	$6,860	N/A
Blue Distinction Transplant	$6,860	N/A
Blue Shield - Ny Highmark Western	$6,860	N/A
Unicare	$6,860	N/A
Blue Shield - Ca	$6,860	N/A
Health Choices	$6,860	N/A
Blue Shield - Wa (Regence)	$6,860	N/A
Blue Shield - Id (Regence)	$6,860	N/A
Bcn Domestic	$6,860	N/A
Blue Benefit Administrators of Massachusetts	$6,860	N/A
Wellpoint	$6,860	N/A
Blue Care Network	$6,860	N/A
Kaiser Domestic	$6,860	N/A
Geha	$8,677	N/A
Harvard Pilgrim Healthcare	$8,677	N/A
Allegiance	$12,427	N/A
Health Partners	$12,427	N/A
Magnacare	$12,427	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 $67.
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 Johnson Memorial Hospital 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.