CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Raritan Bay Medical Center

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $76
  • Cash Discount Price: $51
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Raritan Bay Medical Center is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.59x the Medicare baseline. Located in 530 New Brunswick Ave, Perth Amboy, NJ.
Cash / Self-Pay
$51

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: $51 (107%)
Insurance Median: $76 (159%)
Cash: $51 (107% 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
Aetna $13 - $89 27%
Clover $18 38%
Seoul Medical Group $20 42%
Horizon $34 - $96 71%
Vaccn $51 107%
Karna $51 107%
Blue Cross Blue Shield $51 107%
Wellcare $51 107%
United Community/Americhoice $54 113%
Amerigroup $55 115%
UnitedHealthcare $58 - $81 121%
Oxford $60 125%
Qualcare $66 - $90 138%
Bergen Risk $74 155%
Activecare First McO $74 155%
Cigna $79 - $95 165%
Multiplan - PHCS $84 176%
Amerihealth $86 - $96 180%
Brighton Health Plan $89 186%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 New Brunswick Ave, Perth Amboy, NJ 08861
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals