Pneumonia vaccine injection cost in ID
What a pneumonia vaccine injection costs at ID hospitals — and the fair price to aim for.
Typical commercial prices here are 6% below the fair benchmark (0.94×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Cassia Regional Hospital prices routine shoppable procedures near 4.6× Medicare (p50 2.92×) while skewing captive emergency, lab, and upper-quartile codes to 8.9× Medicare (p75 4.78×, +64% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.04× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (72/100 safety score) with 67% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (36.3% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.4× markup over Medicare rates
- Captive ER (1.4×) & laboratory (1.4×) services average 1.93× higher multiples than routine shoppable care (4.6×)
- Upper-quartile procedures (Q75 4.78×) jump +64% above the median procedure ratio (Q50 2.92×)
- Unnegotiated chargemaster list prices average 9.2× Medicare (14¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
In general, ID hospitals charge about the fair price for this. how we calculate the BaseRate →
Compared with the rest of the country, ID’s fair BaseRate ($46) is about the same as the national fair price of $49.
Cheapest ID hospitals for a pneumonia vaccine injection
- Cassia Regional Hospital · Burley $13
- Saint Alphonsus Regional Medical Center · Boise $30
- St Mary's Hospital · Cottonwood $38
- Bingham Memorial Hospital · Blackfoot $42
- Nell J Redfield Memorial Hospital · Malad City $45
- Mountain View Hospital · Idaho Falls $46
- Madison Memorial Hospital · Rexburg $46
- Boundary Community Hospital · Bonners Ferry $48
- Northwest Specialty Hospital · Post Falls $48
- Kootenai Health · Coeur D'Alene $48
- Eastern Idaho Regional Medical Center · Idaho Falls $51
Audit a Bill or Quote at ID Hospital Benchmark (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $40
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $40).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask ID Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $46 Fair BaseRate ($27 Medicare)
Your bill ($110) is $64 above the denoised Fair BaseRate ($46) and 4.1× the $27 Medicare rate.