CMS Price Transparency Data

Hospital observation (per hour)

Facility: Childrens Hospital of Wisconsin

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $209
Cash Discount Price: $135
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Childrens Hospital of Wisconsin is $209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $135. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.

Cash / Self-Pay

$135

Average discount available for prompt cash payment at this facility.

Insurance Median

$209

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
Froedtert Health	$172 - $209	N/A
Medical College of Wisconsin	$172	N/A
Network Health Plan	$175	N/A
UnitedHealthcare	$181 - $9,035	N/A
Aspirus Health Plan	$185	N/A
Common Ground Healthcare Cooperative	$185 - $209	N/A
Trilogy Health Solutions	$185 - $209	N/A
Wps Health Plan	$187 - $222	N/A
Advocate Aurora Healthcare	$190	N/A
Blue Cross Blue Shield	$192 - $7,526	N/A
Centivo	$192	N/A
Health Partners	$192 - $217	N/A
Employer Health Care Alliance Cooperative	$193	N/A
Dean Health Plan	$197	N/A
Group Health Cooperative of Eau Claire	$197	N/A
Oan LLC	$197	N/A
Security Health Plan	$204	N/A
Health Payment Systems	$208	N/A
Praire States	$209	N/A
Quartz Health Insurance	$209	N/A
Sheboygan Employer's Health Network	$209	N/A
Mayo Clinic Health Solutions	$214	N/A
Aetna	$217 - $219	N/A
Bellin Thedacare	$222	N/A
Cigna	$222	N/A
Group Health Cooperative of South Central Wisconsin	$222	N/A
Prevea Health Network	$222	N/A
Multiplan	$224 - $234	N/A
Coventry Health Care	$234	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 $135.
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 Childrens Hospital of Wisconsin 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.