CMS Price Transparency Data

Hospital observation (per hour)

Facility: AHS Hospital Corp

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $434
Cash Discount Price: $3,483
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at AHS Hospital Corp is $434. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,483. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 651 Willow Grove St, Hackettstown, NJ.

Cash / Self-Pay

$3,483

Average discount available for prompt cash payment at this facility.

Insurance Median

$434

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
Blue Cross Blue Shield	$56 - $5,555	N/A
Medicaid / KanCare	$56 - $5,555	N/A
Untd Hlth Community Plan Behavioral Health [5293]	$61	N/A
Untd Hlth Community Plan [5034]	$61	N/A
Aetna	$67 - $7,777	N/A
Wtc Health Program [5273]	$101 - $404	N/A
Amerihealth [5008]	$202 - $4,841	N/A
Ghi Emblem Health [5122]	$208	N/A
Humana	$208	N/A
Ila Local 1478-2 Welfare Fund [5448]	$208	N/A
Oscar [5213]	$208	N/A
Qualcare [5026]	$208 - $2,312	N/A
Independence Bc [5479]	$232	N/A
Apwu Healthcare [5053]	$258	N/A
Geha [5119]	$258	N/A
Golden Rule Insurance [5124]	$258	N/A
Harvard Pilgrim Healthcare [5133]	$258	N/A
Ntca [5208]	$258	N/A
Oxford Behavioral Health [5291]	$258	N/A
Oxford [5024]	$258	N/A
Surest [5437]	$258	N/A
UnitedHealthcare	$258	N/A
Claim Watcher/Homestead [5488]	$289 - $5,555	N/A
First Managed Care Option [5109]	$289 - $491	N/A
Inservco Workers Compensation [5158]	$289 - $491	N/A
Magnacare [5177]	$289 - $462	N/A
Medlogix/Consumer Health Network (Chn) [5415]	$289 - $491	N/A
Occunet [5490]	$289	N/A
The Fairly Group [5528]	$289	N/A
Gallagher Bassett Workers Comp [5117]	$306	N/A
Liberty Mutual Worker's Comp [5174]	$306	N/A
Pma Workers Comp [5224]	$306	N/A
Sedgwick [5235]	$306	N/A
Sentry Worker's Comp [5489]	$306	N/A
Travelers Workers Compensation [5250]	$306	N/A
Continental Assurance - PHCS [5092]	$318	N/A
Continental Casualty PHCS [5094]	$318	N/A
Coresource [5014]	$318	N/A
Kaiser Permanente [5162]	$318	N/A
Private Healthcare Systems PPO (PHCS) [5227]	$318	N/A
Church Mutual Wc Insurance Company [5524]	$326	N/A
Hanover Workers Comp [5130]	$326	N/A
Hartford Worker's Compensation [5132]	$326	N/A
Hcs Network Solutions [5148]	$326	N/A
Nj Manufacturers Workers Comp [5204]	$326	N/A
Selective Ins Workers Comp [5237]	$326	N/A
Strategic Comp [5518]	$326	N/A
Zurich Workers Comp [5275]	$326	N/A
Allstate [5047]	$345	N/A
Esurance No Fault [5105]	$345	N/A
Geico No Fault [5120]	$345	N/A
Hanover No Fault [5129]	$345	N/A
Liberty Mutual No Fault [5173]	$345	N/A
Nj Manufacturers No Fault [5203]	$345	N/A
Progressive No Fault [5229]	$345	N/A
State Farm No Fault [5241]	$345	N/A
Travelers No Fault [5249]	$345	N/A
Usaa No Fault [5260]	$345	N/A
Zurich No Fault [5274]	$345	N/A
Occunet Secondary [5517]	$347	N/A
The Fairly Group Secondary [5531]	$347	N/A
First Health Network [5108]	$376	N/A
Prime Healthcare [5435]	$396	N/A
Multiplan [5194]	$405	N/A
One Call Workers Comp [5418]	$405	N/A
Praxis Workers Comp [5515]	$405 - $434	N/A
Aig Workers Compensation [5045]	$434	N/A
Amtrust North America Inc [5521]	$434	N/A
Berkshire Hathaway Guard Insurance Company [5529]	$434	N/A
Broadspire Workers Comp [5357]	$434	N/A
Ccmsi Wc [5525]	$434	N/A
Nationwide Mutual Insurance Company [5526]	$434	N/A
Qual-Lynx Wc Preferred [5230]	$434	N/A
Qual-Lynx Wc Standard [5028]	$434	N/A
Sage Adjusting, LLC [5527]	$434	N/A
High Point No Fault [5146]	$462	N/A
Medlogix/Consumer Health Network Pip (Chn) [5414]	$462	N/A
Plymouth Rock Assurance No Fault [5222]	$462	N/A
Chubb Worker's Compensation [5075]	$491	N/A
Claims Resolution Corporation Inc [5520]	$491	N/A
Corvel Corporation [5522]	$491	N/A
Esis [5519]	$491	N/A
Medrisk/Spnet Worker's Comp [5452]	$491	N/A
Atlantic Home Care and Hospice [5055]	$578	N/A
Bundled Cases/Episodic Payment [5492]	$578	N/A
Carba R Generic [5530]	$578	N/A
Carisk Worker's Comp [5501]	$578	N/A
Streamline Worker's Comp [5540]	$578	N/A
Horizon Nj Health [5021]	$4,300	N/A
Cigna	$5,471 - $7,081	N/A
Ambetter / Centene	$5,555	N/A
Amerihealth Administrators Supplemental [5512]	$5,555	N/A
Amerihealth Medigap [5049]	$5,555	N/A
Champva [5354]	$5,555	N/A
Claimdoc [5434]	$5,555	N/A
Cosmetic Surgery/Lap Band/Gastric Bypass [5289]	$5,555	N/A
Fairos [5491]	$5,555	N/A
Highmark Wholecare Health Plan Ip Splits [5464]	$5,555	N/A
Highmark Wholecare Health Plan [5413]	$5,555	N/A
Karen Ann Quinlan [5285]	$5,555	N/A
Luminare Health AHS Retiree [5013]	$5,555	N/A
Medicare (plans)	$5,555 - $5,749	N/A
Sedgwick Wtc Health Program Wc [5514]	$5,555	N/A
Specialty Imaging [5433]	$5,555	N/A
Tricare	$5,555	N/A
UPMC [5455]	$5,555	N/A
Us Family Health Plan [5258]	$5,555	N/A
VA Community Care Network [5403]	$5,555	N/A
Wellcare Behavioral Health [5335]	$5,555	N/A
Wellcare Health Plans Ip Splits [5475]	$5,555	N/A
Wellcare Health Plans [5269]	$5,555	N/A
Amerihealth Caritas Vip Care Ip Splits [5460]	$5,610	N/A
Amerihealth Caritas Vip Care [5313]	$5,610	N/A
Kindred Giralda Hospital [5341]	$6,110	N/A
Evolution Healthcare [5438]	$6,437	N/A
Healthez [5445]	$6,437	N/A
Mvp Health Care [5197]	$6,437	N/A
Nalc [5198]	$6,437	N/A
Seafarers Health and Benefits Plan [5343]	$6,437	N/A
Tufts Health Plan [5344]	$6,437	N/A
Webtpa [5447]	$6,437	N/A
Allied Benefit Systems [5046]	$7,081	N/A
Centivo [5405]	$7,081 - $7,960	N/A
Iaa - Insurance Administrators of America [5482]	$7,081	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 $3,483.
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 AHS Hospital Corp 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.