CMS Price Transparency Data

Pneumonia vaccine injection

Facility: West Valley Medical Center

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $14
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 0.29x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at West Valley Medical Center is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 0.29x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.
Cash / Self-Pay
$16

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

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: $16 (33%)
Insurance Median: $14 (29%)
Cash: $16 (33% of Medicare)
Ins. Median: $14 (29% 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

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Select Health Idaho (Eirmc Only) $5 10%
Corizon Health $6 13%
True Blue $6 13%
Cigna $9 19%
Moda $10 21%
United $10 21%
Pacificsource Health $10 21%
St Luke's Health Partners $11 23%
Aetna $13 27%
Multiplan $13 27%
Four Rivers Hospice $13 27%
Humana $14 29%
Geha PPO USA $14 29%
St Alphonsus Health $15 31%
Coventry First Health $15 31%
Blue Cross Blue Shield $16 - $23 33%
Molina $17 36%
Regence $123 257%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1717 Arlington Street, Caldwell, ID 83605
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals