CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Children's Specialized Hospital

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $60
  • Cash Discount Price: $39
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Children's Specialized Hospital is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.25x the Medicare baseline. Located in 200 Somerset St, New Brunswick, NJ.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $39 (82%)
Insurance Median: $60 (125%)
Cash: $39 (82% of Medicare)
Ins. Median: $60 (125% 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
Blue Cross Blue Shield $8 - $76 17%
Cigna $47 98%
First Health $47 98%
Emblem Health $53 111%
Amerihealth $59 123%
Aetna $60 125%
Fidelis Care $60 125%
Wellpoint $60 125%
Qualcare Inc $61 128%
UnitedHealthcare $61 128%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Somerset St, New Brunswick, NJ 08901
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens