CMS Price Transparency Data

Hospital observation (per hour)

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $72
Cash Discount Price: $46
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Childrens Hospital of Wisconsin Fox Valley is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 130 Second St, Neenah, WI.

Cash / Self-Pay

$46

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

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	$59 - $72	N/A
Medical College of Wisconsin	$59	N/A
Network Health Plan	$60	N/A
UnitedHealthcare	$62 - $9,035	N/A
Aspirus Health Plan	$63	N/A
Common Ground Healthcare Cooperative	$63 - $72	N/A
Trilogy Health Solutions	$63 - $72	N/A
Wps Health Plan	$64 - $76	N/A
Advocate Aurora Healthcare	$65	N/A
Blue Cross Blue Shield	$66 - $7,526	N/A
Centivo	$66	N/A
Employer Health Care Alliance Cooperative	$66	N/A
Health Partners	$66 - $74	N/A
Dean Health Plan	$67	N/A
Group Health Cooperative of Eau Claire	$67	N/A
Oan LLC	$67	N/A
Security Health Plan	$70	N/A
Health Payment Systems	$71	N/A
Praire States	$72	N/A
Quartz Health Insurance	$72	N/A
Sheboygan Employer's Health Network	$72	N/A
America's PPO	$73	N/A
Aetna	$74 - $75	N/A
Bellin Thedacare	$76	N/A
Cigna	$76	N/A
Group Health Cooperative of South Central Wisconsin	$76	N/A
Healthsmart	$76	N/A
Prevea Health Network	$76	N/A
Multiplan	$77 - $80	N/A
Coventry Health Care	$80	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 $46.
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 Fox Valley 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.