CMS Price Transparency Data

Pneumonia vaccine injection

Facility: The Hospital at Westlake Medical Center

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $42
  • Cash Discount Price: $91
  • vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at The Hospital at Westlake Medical Center is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 0.88x the Medicare baseline. Located in 5656 Bee Caves Road, Suite M-302, Austin, TX.
Cash / Self-Pay
$91

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $91 (190%)
Insurance Median: $42 (88%)
Cash: $91 (190% of Medicare)
Ins. Median: $42 (88% 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
United_Healthcare $24 50%
Aetna $42 - $116 88%
Ambetter / Centene $42 88%
Blue Cross Blue Shield $42 - $178 88%
Edhp $42 88%
Humana $42 - $169 88%
McR_United $42 88%
Medicare (plans) $42 88%
Sendero $42 88%
Tricare $42 88%
Triwest $42 88%
Wellcare $42 88%
Cigna $57 119%
90_Degree_Benefits $64 134%
Superior_Mcd $117 245%
Scott_And_White $143 299%
Multiplan $169 353%
Beech_Street $182 380%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5656 Bee Caves Road, Suite M-302, Austin, TX 78746
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals