Pneumonia vaccine injection
Facility: Physicians Regional Medical Center
Billing Code: G0009 (HCPCS)
This hospital's typical commercial price is $44 compared to the $45 fair price benchmark.
3-Star CMS clinical quality rating paired with 0.98× fair market pricing.
Highest price of the 9 TN hospitals we have prices for — worth calling around.
Black dot = this hospital, among the 9 TN hospitals with a price for this procedure. Full list below.
A fair price for a Pneumonia vaccine injection is about $45 (about 0.9× the $48 Medicare rate). Physicians Regional Medical Center charges insurers about $44, or about $86 in cash — about the fair price. Located in Powell, TN.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
5 of 6 major insurers have a published price at this hospital
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 |
|---|---|---|
| UnitedHealthcaremajor | $14 - $156 | 29% |
| Blue Cross Blue Shieldmajor | $5 - $81 | 10% |
| Aetnamajor | $43 - $177 | 90% |
| Cignamajor | $98 | 205% |
| Humanamajor | $42 | 88% |
| Ambetter (Centene) | $79 | 165% |
| Amerigroup | $27 - $44 | 56% |
| Cigna HealthSpring | $43 | 90% |
| Devoted Health | $42 | 88% |
| WellCare | $44 | 92% |
| + 5 smaller / regional plans | $42 - $79 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Physicians Regional Medical Center
Compare: Pneumonia vaccine injection at other TN hospitals
- Erlanger Medical Center · Chattanooga $26
- Marshall Medical Center · Lewisburg $32
- University Health System, Inc · Knoxville $42
- Methodist Hospitals of Memphis · Memphis $42
- Maury Regional Hospital · Columbia $42
- Lincoln Medical Center · Fayetteville $43
- Jackson-Madison County General Hospital · Jackson $44
- Sycamore Shoals Hospital · Elizabethton $44
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Physicians Regional Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $147
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $147).
Self-Pay Cash Rate ($86) Beats Your Bill
Physicians Regional Medical Center's published 45 CFR § 180 self-pay cash rate is $86 (vs. $44 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $45 Fair BaseRate ($48 Medicare)
Your bill ($404) is $359 above the denoised Fair BaseRate ($45) and 8.4× the $48 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.