CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Monmouth Medical Center-Southern Campus

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $85
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 1.78x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Monmouth Medical Center-Southern Campus is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.78x the Medicare baseline. Located in 600 River Ave, Lakewood, NJ.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$85

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: $44 (92%)
Insurance Median: $85 (178%)
Cash: $44 (92% of Medicare)
Ins. Median: $85 (178% 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
UnitedHealthcare $34 - $51 71%
Fidelis Care $35 - $50 73%
Aetna $37 - $155 77%
Blue Cross Blue Shield $50 - $180 105%
Clover $50 105%
Humana $50 105%
Wellpoint $50 - $105 105%
Cigna $82 - $109 171%
Emblem Health $88 184%
Wellcare $100 209%
First Health $111 232%
Qualcare Inc $142 - $152 297%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 River Ave, Lakewood, NJ 08701
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals