CMS Price Transparency Data

Hospital observation (per hour)

Facility: Nemours Children's Hospital, Delaware

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $192
Cash Discount Price: $336
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Nemours Children's Hospital, Delaware is $192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $336. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.

Cash / Self-Pay

$336

Average discount available for prompt cash payment at this facility.

Insurance Median

$192

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
Keystone First Hlth Plan	$67 - $145	N/A
Us Family Health Plan	$77	N/A
Carefirst Md Community Health Plan	$86	N/A
Amerihealth Caritas Delaware	$103 - $192	N/A
Blue Cross Blue Shield	$104 - $297	N/A
Celtic Transplant for De First Health	$118	N/A
Delaware First Health	$121	N/A
UnitedHealthcare	$123 - $210	N/A
Wellpoint Maryland	$124	N/A
Kidz Partners	$127	N/A
Health Partners	$130	N/A
UPMC	$133	N/A
Fidelis	$134	N/A
Aetna	$143 - $195	N/A
Priority Partners John Hopkins	$165	N/A
Six Degrees Health Transplant	$168	N/A
Cigna	$188 - $212	N/A
Ambetter / Centene	$192	N/A
Geisinger Health Plan	$202	N/A
Integra Administrative Group	$202	N/A
Great West-One Health Plan	$212	N/A
Star Healthcare Network	$218	N/A
Six Degrees Health	$218	N/A
National Transplant Network (Ntn)	$218	N/A
Life Trac Solid Organ and Bmt Transplant	$235	N/A
First Health Network	$319	N/A
Multiplan	$319	N/A
Interlink Transplant Network	$319	N/A
Insurance Administrators of America	$319	N/A
Three Rivers Provider Network	$319	N/A
Private Healthcare Systems	$319	N/A
Preferred Healthcare	$319	N/A
Celtic Transplant	$336	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 $336.
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 Nemours Children's Hospital, Delaware 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.