CMS Price Transparency Data

Hospital observation (per hour)

Facility: Clara Maass Medical Center

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $4,582
Cash Discount Price: $1,094
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Clara Maass Medical Center is $4,582. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,094. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in One Clara Maass Drive, Belleville, NJ.

Cash / Self-Pay

$1,094

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,582

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
UnitedHealthcare	$38 - $8,837	N/A
Fidelis Care	$39 - $714	N/A
Aetna	$42 - $6,748	N/A
First Health	$180 - $3,300	N/A
Wellpoint	$1,295	N/A
Blue Cross Blue Shield	$2,492 - $9,078	N/A
Qualcare Inc	$3,047 - $3,186	N/A
Amerihealth	$4,315 - $4,848	N/A
Cigna	$4,982 - $6,667	N/A
Emblem Health	$5,305	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 $1,094.
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 Clara Maass 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.