CMS Price Transparency Data

Flu vaccine injection

Facility: Community Medical Center

Billing Code: G0008 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0008
  • Insurance Median: $100
  • Cash Discount Price: $38
  • vs. Medicare Baseline: 2.09x Medicare
The contracted insurance negotiated median rate for a Flu vaccine injection at Community Medical Center is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 2.09x the Medicare baseline. Located in 99 Rt 37 West, Toms River, NJ.
Cash / Self-Pay
$38

Average discount available for prompt cash payment at this facility.

Insurance Median
$100

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: $38 (79%)
Insurance Median: $100 (209%)
Cash: $38 (79% of Medicare)
Ins. Median: $100 (209% 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 209% of the Medicare baseline (a markup of 109%). 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
Fidelis Care $23 - $50 48%
UnitedHealthcare $23 - $51 48%
Aetna $25 - $102 52%
Blue Cross Blue Shield $50 - $169 105%
Clover Health $50 105%
Humana $50 105%
Wellpoint $50 - $105 105%
Emblem Health $88 184%
Wellcare $100 209%
Cigna $110 - $147 230%
First Health $111 232%
Qualcare Inc $123 - $132 257%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 99 Rt 37 West, Toms River, NJ 08755
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals