CMS Price Transparency Data

Flu vaccine injection

Facility: St Joseph's Hospital

Billing Code: G0008 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0008
  • Insurance Median: $103
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 2.15x Medicare
The contracted insurance negotiated median rate for a Flu vaccine injection at St Joseph's Hospital is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 2.15x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$103

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: $87 (182%)
Insurance Median: $103 (215%)
Cash: $87 (182% of Medicare)
Ins. Median: $103 (215% 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 215% of the Medicare baseline (a markup of 115%). 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.

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
Amish Community $34 71%
UnitedHealthcare $48 - $121 100%
Caterpillar, Inc. $63 132%
Aetna $73 - $85 153%
Wellfirst $77 161%
Molina Healthcare $78 163%
Cigna $81 169%
Meridian Health Plan $82 171%
First Health $89 186%
Healthlink $103 215%
Multiplan/Phcs $103 215%
Provider Network of America $109 228%
Healthcare Finest Network (Hfn) $109 228%
Illinois Breast and Cervical Cancer Program $121 253%
Health Alliance Medical Plans $121 253%
Interplan $121 253%
Qtc Medical Group of Illinois $121 253%
Mental Health Network $121 253%
Healthscope $121 253%
Current Health Solutions $121 253%
Consociate Group $121 253%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals