CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Ochsner Stennis Memorial Hospital

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0009
Insurance Median: $81
Cash Discount Price: $96
vs. Medicare Baseline: 1.69x Medicare

The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Ochsner Stennis Memorial Hospital is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.69x the Medicare baseline. Located in 14365 Highway 16 West, De Kalb, MS.

Cash / Self-Pay

$96

Average discount available for prompt cash payment at this facility.

Insurance Median

$81

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: $96 (201%)

Insurance Median: $81 (169%)

Cash: $96 (201% of Medicare)

Ins. Median: $81 (169% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
UnitedHealthcare	$13 - $31	27%
Blue Cross Blue Shield	$14 - $111	29%
Humana	$15 - $83	31%
Aetna	$29 - $90	61%
Cor Vel	$34 - $52	71%
Prime Health Services PPO -Workers Comp	$34 - $51	71%
Cigna	$61 - $83	128%
Ambetter / Centene	$73 - $84	153%
Magnolia Health Plan – Wellcare By All Well of Mississippi	$73 - $84	153%
Medicare (plans)	$73 - $96	153%
Shared Health Mississippi	$76 - $88	159%
Primewell Health Services Commercial Exchange Plan	$81 - $93	169%
Primewell Health Services – Commercial	$81 - $93	169%
Select Administrative Services Network	$85 - $97	178%
Claritev D/B/A Multiplan/Phcs/American Life Care	$91 - $104	190%
Zelis	$91 - $104	190%
Prime Health Services PPO	$97 - $111	203%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $96.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0009.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ochsner Stennis Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0009.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.