Pneumonia vaccine injection
Facility: Johnson Memorial Hospital
Billing Code: G0009 (HCPCS)
- CPT Billing Code: G0009
- Insurance Median: $143
- Cash Discount Price: $95
- vs. Medicare Baseline: 2.99x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 299% of the Medicare baseline (a markup of 199%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 | $55 - $172 | 115% |
| Aetna | $55 - $134 | 115% |
| UnitedHealthcare | $55 - $172 | 115% |
| Medicare (plans) | $55 - $58 | 115% |
| Cca Senior Care Options | $56 | 117% |
| Cigna | $57 - $157 | 119% |
| Geha | $69 | 144% |
| Harvard Pilgrim Healthcare | $69 | 144% |
| Fallon Health | $73 | 153% |
| Health New England | $112 | 234% |
| Diversified Administrators | $118 | 247% |
| Innovative Health Plan II | $118 | 247% |
| Claimdoc | $118 | 247% |
| Centivo | $131 | 274% |
| Webtpa | $134 | 280% |
| Gravie Admin Services | $134 | 280% |
| 1199 National Benefit Fund | $134 | 280% |
| Nippon Life Ins | $134 | 280% |
| Meritain | $134 | 280% |
| Luminare Health | $134 | 280% |
| Hap | $134 | 280% |
| Allied Benefit Systems | $134 | 280% |
| Prime Health Services | $138 | 288% |
| Pan-American Life | $143 | 299% |
| Pai | $143 | 299% |
| Manhattan Life | $143 | 299% |
| Allied National Global Care | $143 | 299% |
| Lifetime Benefit Solutions | $143 | 299% |
| Dean Health | $143 | 299% |
| Ghc Scw | $143 | 299% |
| Family Life Insurance Company | $143 | 299% |
| Mvp | $143 | 299% |
| Paramount HMO | $143 | 299% |
| PHCS | $143 | 299% |
| Trinity Health Share | $143 | 299% |
| International Benefit Administrators | $143 | 299% |
| Multiplan | $143 | 299% |
| Christian Care Ministry | $143 | 299% |
| Medi Share | $143 | 299% |
| Asrm - Reliance Standard Life Insurance | $143 | 299% |
| Health Smart | $146 | 305% |
| Health Partners | $157 | 328% |
| Magnacare | $157 | 328% |
| Allegiance | $157 | 328% |
| Blue Shield - PA (Highmark) | $172 | 360% |
| United Behavioral Health Eap | $172 | 360% |
| Wellpoint | $172 | 360% |
| Connecticare | $172 | 360% |
| Blue Care Network | $172 | 360% |
| Blue Shield - Ca | $172 | 360% |
| Bcn Domestic | $172 | 360% |
| Unicare | $172 | 360% |
| Blue Shield - Ny Highmark Western | $172 | 360% |
| Blue Distinction Transplant | $172 | 360% |
| Health Choices | $172 | 360% |
| Pre-Employment | $172 | 360% |
| Wc Domestic | $172 | 360% |
| Blue Shield - Wa (Regence) | $172 | 360% |
| Blue Shield - Ny Highmark Northeastern | $172 | 360% |
| Blue Shield - Id (Regence) | $172 | 360% |
| Kaiser Domestic | $172 | 360% |
| Blue Benefit Administrators of Massachusetts | $172 | 360% |