CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Robert Wood Johnson University Hospital at Rahway

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0009
Insurance Median: $59
Cash Discount Price: $22
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Robert Wood Johnson University Hospital at Rahway is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.23x the Medicare baseline. Located in 865 Stone St, Rahway, NJ.

Cash / Self-Pay

$22

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $22 (46%)

Insurance Median: $59 (123%)

Cash: $22 (46% of Medicare)

Ins. Median: $59 (123% 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	$19 - $51	40%
Fidelis Care	$20 - $50	42%
Aetna	$21 - $154	44%
Blue Cross Blue Shield	$26 - $96	54%
Clover Health	$50	105%
Humana	$50	105%
Wellpoint	$50	105%
Cigna	$85 - $114	178%
Emblem Health	$88	184%
Wellcare	$100	209%
First Health	$104	217%
Qualcare Inc	$117	245%

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 $22.
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 Robert Wood Johnson University Hospital at Rahway 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.