CMS Price Transparency Data

Flu vaccine injection

Facility: Saint Mary's Hospital

Billing Code: G0008 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0008
  • Insurance Median: $131
  • Cash Discount Price: $94
  • vs. Medicare Baseline: 2.74x Medicare
The contracted insurance negotiated median rate for a Flu vaccine injection at Saint Mary's Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 2.74x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$94

Average discount available for prompt cash payment at this facility.

Insurance Median
$131

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: $94 (196%)
Insurance Median: $131 (274%)
Cash: $94 (196% of Medicare)
Ins. Median: $131 (274% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 274% of the Medicare baseline (a markup of 174%). 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.

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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
Aetna $55 - $134 115%
Blue Cross Blue Shield $55 - $166 115%
Medicare (plans) $55 - $57 115%
UnitedHealthcare $55 - $170 115%
Cca Senior Care Options $56 117%
Cigna $57 - $136 119%
Geha $75 157%
Harvard Pilgrim Healthcare $75 157%
Carelon Behavioral Health $85 178%
Health New England $90 188%
Allegiance $92 192%
Health Partners $92 192%
Magnacare $92 192%
Centivo $112 234%
Claimdoc $118 247%
Diversified Administrators $118 247%
Innovative Health Plan II $118 247%
Allied National Global Care $131 274%
Asrm - Reliance Standard Life Insurance $131 274%
Christian Care Ministry $131 274%
Dean Health $131 274%
Fallon Health $131 274%
Family Life Insurance Company $131 274%
Ghc Scw $131 274%
International Benefit Administrators $131 274%
Lifetime Benefit Solutions $131 274%
Manhattan Life $131 274%
Medi Share $131 274%
Multiplan $131 274%
Mvp $131 274%
PHCS $131 274%
Pai $131 274%
Pan-American Life $131 274%
Paramount HMO $131 274%
Trinity Health Share $131 274%
1199 National Benefit Fund $134 280%
Allied Benefit Systems $134 280%
Gravie Admin Services $134 280%
Hap $134 280%
Luminare Health $134 280%
Meritain $134 280%
Nippon Life Ins $134 280%
Webtpa $134 280%
Prime Health Services $136 284%
Health Smart $144 301%
Bcn Domestic $166 347%
Blue Benefit Administrators of Massachusetts $166 347%
Blue Care Network $166 347%
Blue Distinction Transplant $166 347%
Blue Shield - Ca $166 347%
Blue Shield - Id (Regence) $166 347%
Blue Shield - Ny Highmark Northeastern $166 347%
Blue Shield - Ny Highmark Western $166 347%
Blue Shield - PA (Highmark) $166 347%
Blue Shield - Wa (Regence) $166 347%
Health Choices $166 347%
Kaiser Domestic $166 347%
Pre-Employment $166 347%
Unicare $166 347%
Wc Domestic $166 347%
Wellpoint $166 347%
Connecticare $170 355%
United Behavioral Health Eap $170 355%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals