CMS Price Transparency Data
Pneumonia vaccine injection
Facility: Clovis Community Medical Center
Billing Code: G0009 (HCPCS)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: G0009
- Insurance Median: $60
- Cash Discount Price: $104
- vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Clovis Community Medical Center is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.25x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$104
Average discount available for prompt cash payment at this facility.
Insurance Median
$60
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$47.84
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $47.84 (100%)
Cash / Self-Pay: $104 (217%)
Insurance Median: $60 (125%)
Cash: $104 (217% of Medicare)
Ins. Median: $60 (125% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $47.84 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
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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 Shield | $28 - $74 | 59% |
| Central Valley Medical Providers | $32 - $91 | 67% |
| Community Care | $33 | 69% |
| Aetna | $48 - $65 | 100% |
| Kaiser | $48 | 100% |
| Employer 90/40 | $52 | 109% |
| Healthnet Sante - Sub Cap Dual Risk | $60 | 125% |
| Healthnet Sante Dual Risk | $60 | 125% |
| Blue Shield Promise - Imperial | $60 | 125% |
| Healthnet Sante | $60 | 125% |
| Generic Victims of Crime | $60 | 125% |
| Sante Sub Cap-Blue Shield/Sante | $60 | 125% |
| Care1St HMO - Ehs | $60 | 125% |
| Blue Shield 65 Plus HMO First Choice | $60 | 125% |
| Healthnet HMO - Dhmso | $60 | 125% |
| Sante Sub Cap Healthnet Seniority | $60 | 125% |
| Humana | $60 - $110 | 125% |
| Meritage Brand New Day | $60 | 125% |
| Todays Pyramid | $60 | 125% |
| Blue Shield Saint Agnes | $60 | 125% |
| Generic Bscphp | $60 | 125% |
| Medicare (plans) | $60 | 125% |
| Sante-Sub Cap Ma Brand New Day | $60 | 125% |
| Bscphp HMO - First Choice | $60 | 125% |
| Sante-Healthnet Seniority | $60 | 125% |
| Healthnet HMO - La Salle | $60 | 125% |
| Railroad Part A | $60 | 125% |
| Us Marshal | $60 | 125% |
| Sante-Blue Shield/Sante | $60 | 125% |
| Meritage Blue Shield 65 Plus | $60 | 125% |
| Gemcare HMO | $60 | 125% |
| Generic | $60 | 125% |
| Brand New Day | $60 | 125% |
| Scan Health Plan | $60 | 125% |
| Sequoia Pace - Peak Tpa | $60 | 125% |
| Healthnet HMO - Sante | $60 | 125% |
| Medi-Cal Innovative Integrated Health | $60 | 125% |
| Blue Cross Blue Shield | $60 - $83 | 125% |
| Meritage Healthnet HMO | $60 | 125% |
| Hartford Life Supplement | $60 | 125% |
| Victims of Crime | $60 | 125% |
| Sante | $60 | 125% |
| Bscphp - First Choice | $60 | 125% |
| Railroad Part A & B | $60 | 125% |
| Bscphp - Dhmso | $60 | 125% |
| Blue Shield Hmo-Cvmp/Medpro | $60 | 125% |
| Wellcare | $60 | 125% |
| UnitedHealthcare | $60 - $68 | 125% |
| Blue Shield 65 Plus HMO Ehs | $60 | 125% |
| Cigna | $60 - $81 | 125% |
| Cares Act Provider Relief Fund | $60 | 125% |
| Railroad Part B | $60 | 125% |
| Blue Shield Sante | $60 | 125% |
| Advantek Table Mountain Rancheria Tribal Member | $60 | 125% |
| Healthnet HMO - Cvmp/Medpro | $60 | 125% |
| Innovative Integrated Health Community Plans HMO | $66 | 138% |
| Alignment Health Plan | $66 | 138% |
| Champion Health Plan of California Ma | $66 | 138% |
| Imperial Health Plan HMO | $69 | 144% |
| Nx Health Network PPO | $72 | 151% |
| Central Ca Indian Health | $72 | 151% |
| Healthnet | $76 | 159% |
| Correctcare Integrated Health | $78 | 163% |
| Healthsmart | $88 - $104 | 184% |
| Coventry Health Care (First Health Network) | $98 | 205% |
| Network By Design | $98 | 205% |
| PHCS | $110 | 230% |
| Generic Multiplan | $110 | 230% |
| Coalinga State Hospital | $120 | 251% |
| Naphcare Inc-Mendota | $129 | 270% |
| Well Path (Cfmg) | $143 | 299% |