CMS Price Transparency Data

Flu vaccine injection

Facility: Saint Michael's Medical Center

Billing Code: G0008 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0008
  • Insurance Median: $76
  • Cash Discount Price: $54
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Flu vaccine injection at Saint Michael's Medical Center is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.59x the Medicare baseline. Located in 111 Central Avenue, Newark, NJ.
Cash / Self-Pay
$54

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: $54 (113%)
Insurance Median: $76 (159%)
Cash: $54 (113% 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
Tricare $43 90%
Aetna $54 - $115 113%
Amerihealth $54 113%
Horizon $54 - $111 113%
Humana $54 113%
Medicare (plans) $54 113%
New Jersey Out of State $54 113%
UnitedHealthcare $54 - $213 113%
Wellpoint Amerigroup $54 113%
Clover Health $56 117%
Wellcare $56 - $73 117%
Curana $57 119%
Employer Direct Healthcare $76 159%
Naphcare $84 176%
Cigna $87 182%
Fairprice Healthcare Holdings - Fphh $87 182%
Coventry $109 228%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 111 Central Avenue, Newark, NJ 07102
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals