CMS Price Transparency Data

Hospital observation (per hour)

Facility: St Joseph's University Medical Center Inc

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $303
Cash Discount Price: $466
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at St Joseph's University Medical Center Inc is $303. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $466. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 703 Main St, Paterson, NJ.

Cash / Self-Pay

$466

Average discount available for prompt cash payment at this facility.

Insurance Median

$303

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
Aetna	$50 - $4,592	N/A
UnitedHealthcare	$83 - $7,598	N/A
Amerihealth	$91 - $5,209	N/A
Fidelis Care of New Jersey	$93 - $137	N/A
Blue Cross Blue Shield	$100 - $406	N/A
Ambetter / Centene	$140	N/A
Private Healthcare Systems	$303	N/A
Multiplan	$350	N/A
Consumer Health Network	$419	N/A
Longevity Health Plan	$419	N/A
Oscar	$439	N/A
Cigna	$466	N/A
Horizon New Jersey Health	$1,193	N/A
Wellpoint	$2,300	N/A
Magnacare	$5,539	N/A
Oxford	$7,000	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 $466.
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 University Medical Center Inc 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.