Pneumonia vaccine injection
Facility: Mount Sinai Rehabilitation Hospital Inc
Billing Code: G0009 (HCPCS)
- CPT Billing Code: G0009
- Insurance Median: $138
- Cash Discount Price: $95
- vs. Medicare Baseline: 2.88x 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 288% of the Medicare baseline (a markup of 188%). 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 | $54 - $172 | 113% |
| Aetna | $54 - $139 | 113% |
| Medicare (plans) | $54 - $56 | 113% |
| UnitedHealthcare | $54 - $172 | 113% |
| Cigna | $55 - $155 | 115% |
| Cca Senior Care Options | $55 | 115% |
| Health New England | $91 | 190% |
| Innovative Health Plan II | $115 | 240% |
| Claimdoc | $115 | 240% |
| Diversified Administrators | $115 | 240% |
| PHCS | $117 | 245% |
| Paramount HMO | $117 | 245% |
| Allied National Global Care | $117 | 245% |
| Trinity Health Share | $117 | 245% |
| Family Life Insurance Company | $117 | 245% |
| Asrm - Reliance Standard Life Insurance | $117 | 245% |
| Christian Care Ministry | $117 | 245% |
| Pai | $117 | 245% |
| Mvp | $117 | 245% |
| Lifetime Benefit Solutions | $117 | 245% |
| Manhattan Life | $117 | 245% |
| Pan-American Life | $117 | 245% |
| Multiplan | $117 | 245% |
| International Benefit Administrators | $117 | 245% |
| Ghc Scw | $117 | 245% |
| Dean Health | $117 | 245% |
| Medi Share | $117 | 245% |
| Prime Health Services | $138 | 288% |
| Allied Benefit Systems | $139 | 291% |
| Meritain | $139 | 291% |
| Luminare Health | $139 | 291% |
| Hap | $139 | 291% |
| Nippon Life Ins | $139 | 291% |
| Webtpa | $139 | 291% |
| Gravie Admin Services | $139 | 291% |
| 1199 National Benefit Fund | $139 | 291% |
| Connecticare | $140 - $155 | 293% |
| Health Smart | $146 | 305% |
| Allegiance | $155 | 324% |
| Magnacare | $155 | 324% |
| Health Partners | $155 | 324% |
| Blue Shield - PA (Highmark) | $172 | 360% |
| Blue Shield - Ny Highmark Northeastern | $172 | 360% |
| Pre-Employment | $172 | 360% |
| Unicare | $172 | 360% |
| Kaiser Domestic | $172 | 360% |
| Blue Shield - Id (Regence) | $172 | 360% |
| Blue Shield - Ca | $172 | 360% |
| Harvard Pilgrim Healthcare | $172 | 360% |
| Blue Benefit Administrators of Massachusetts | $172 | 360% |
| Blue Care Network | $172 | 360% |
| Geha | $172 | 360% |
| Blue Shield - Wa (Regence) | $172 | 360% |
| Wc Domestic | $172 | 360% |
| Blue Distinction Transplant | $172 | 360% |
| Blue Shield - Ny Highmark Western | $172 | 360% |
| Health Choices | $172 | 360% |
| Bcn Domestic | $172 | 360% |