CMS Price Transparency Data

Hospital observation (per hour)

Facility: UPMC Kane

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $43
Cash Discount Price: $32
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at UPMC Kane is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 4372 Route 6, Kane, PA.

Cash / Self-Pay

$32

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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
Blue Cross Blue Shield	$20 - $78	N/A
UPMC Health Plan	$20 - $3,247	N/A
Highmark Wholecare (Prev Gateway)	$21 - $2,569	N/A
UnitedHealthcare	$21 - $747	N/A
Aetna	$21 - $1,074	N/A
Amerihealth Caritas	$22 - $2,137	N/A
Cigna	$38 - $1,216	N/A
Horizon Health Plan	$38	N/A
Multiplan	$40	N/A
Intergroup	$43	N/A
Health Coalition Partners	$43	N/A
Focus Healthcare	$51	N/A
PA Health & Wellness	$2,137	N/A
Geisinger	$2,207	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 $32.
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 UPMC Kane 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.