CMS Price Transparency Data

Hospital observation (per hour)

Facility: St Joseph's Hospital

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $74
Cash Discount Price: $56
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at St Joseph's Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.

Cash / Self-Pay

$56

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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 (%)

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
UnitedHealthcare	$16 - $78	N/A
Aetna	$16 - $78	N/A
Sae Hospice	$16 - $78	N/A
Clear Spring Health of Illinois	$16 - $78	N/A
Blue Cross Blue Shield	$16 - $78	N/A
Humana	$16 - $78	N/A
Molina Healthcare	$16 - $78	N/A
Amish Community	$22	N/A
Naphcare	$33 - $164	N/A
Celtic Insurance Company	$34 - $78	N/A
Hopetrust	$39 - $78	N/A
Claim Doc	$39 - $195	N/A
Wellfirst	$50	N/A
Cigna	$52	N/A
First Health	$58	N/A
Multiplan/Phcs	$66	N/A
Healthlink	$66	N/A
Provider Network of America	$70	N/A
Healthcare Finest Network (Hfn)	$70	N/A
Mental Health Network	$78	N/A
Consociate Group	$78	N/A
Health Alliance Medical Plans	$78	N/A
Qtc Medical Group of Illinois	$78	N/A
Interplan	$78	N/A
Illinois Breast and Cervical Cancer Program	$78	N/A
Healthscope	$78	N/A
Current Health Solutions	$78	N/A
Caterpillar, Inc.	$78	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 $56.
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 Joseph's 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.