CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Ascension St John Sapulpa

Billing Code: G0009 (HCPCS)

The BaseRate · fair price low confidence
A fair price for this
$39
about 0.8× the $48 Medicare rate · typically $10–$148
modeled estimate · not a bill or quote
Medicare pays $48 Fair price $39 Cash price $22 Hospital's list price $59

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

1 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield UnitedHealthcareAetnaCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
Blue Cross Blue Shieldmajor $10 21%

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 1004 East Bryan, Sapulpa, OK 74066
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals