CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Eastern Idaho Regional Medical Center

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $76
  • Cash Discount Price: $131
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Eastern Idaho Regional Medical Center is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.59x the Medicare baseline. Located in 3100 Channing Way, Idaho Falls, ID.
Cash / Self-Pay
$131

Average discount available for prompt cash payment at this facility.

Insurance Median
$76

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: $131 (274%)
Insurance Median: $76 (159%)
Cash: $131 (274% of Medicare)
Ins. Median: $76 (159% 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
Blue Cross Blue Shield $17 - $124 36%
Molina $17 36%
Select Health $40 84%
Select Health Ichn Brightpath $40 - $44 84%
Select Health Idaho (Eirmc Only) $42 88%
Aetna $52 - $64 109%
Doug Andrus Distributing $52 109%
Pacificsource Health $55 - $70 115%
University of Utah $55 115%
Mountain Health Co-Op $65 - $98 136%
Interwest Health $66 - $118 138%
Cigna $72 151%
United $76 159%
First Choice Health of Washington $78 163%
Moda $81 169%
Dmba $84 176%
Prime Health $98 - $111 205%
Geha PPO USA $105 219%
Humana $110 230%
Multiplan $110 - $118 230%
St. John's Health Network $118 247%
First Choice of the Midwest $118 247%
Coventry First Health $119 249%
Regence $124 259%
Shashone-Bannock Tribal Health $131 274%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Channing Way, Idaho Falls, ID 83404
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals