CMS Price Transparency Data

Hospital observation (per hour)

Facility: Charleston Area Medical Center

Billing Code: G0378 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0378
Insurance Median: $95
Cash Discount Price: $158
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hospital observation (per hour) at Charleston Area Medical Center is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$158

Average discount available for prompt cash payment at this facility.

Insurance Median

$95

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
Unicare Health Plan of West Virginia Inc.	$37	N/A
The Health Plan of West Virginia Inc.	$37 - $153	N/A
Triwest VA	$38	N/A
Choicecare Network	$40 - $155	N/A
Blue Cross Blue Shield	$40 - $144	N/A
West Virginia Senior Advantage Inc.	$41	N/A
UnitedHealthcare	$41 - $155	N/A
Aetna	$49 - $155	N/A
Optimum Choice Inc.	$63	N/A
Integrated Medical Solutions	$77	N/A
Naphcare	$79	N/A
Tricare	$95	N/A
Caresource	$99	N/A
City of Charleston	$118	N/A
Cigna	$147	N/A
Three Rivers Providers Network	$153	N/A
Healthsmart	$155	N/A
Multiplan	$155	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 $158.
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 Charleston Area Medical Center 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.