CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Methodist Hospital Stone Oak

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $49
  • Cash Discount Price: $132
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Methodist Hospital Stone Oak is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.02x the Medicare baseline. Located in 1139 E Sonterra Blvd,, San Antonio, TX.
Cash / Self-Pay
$132

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $132 (276%)
Insurance Median: $49 (102%)
Cash: $132 (276% of Medicare)
Ins. Median: $49 (102% 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
Superior Health $7 15%
Community First Health Plans $16 - $36 33%
Amerigroup $18 - $19 38%
Imperial Insurance $25 52%
Oscar $26 - $27 54%
United $32 - $60 67%
Aetna $35 - $66 73%
Cigna $38 - $51 79%
Blue Cross Blue Shield $39 - $327 82%
Focus Health Solutions $40 84%
Healthcare Highways $41 86%
Valenz $46 96%
Evry Health $49 102%
Curative Administrators $53 111%
First Health $58 - $59 121%
Fidelis Securecare $59 - $60 123%
National Choicecare $66 138%
Texas Healthcare Foundation Heb $66 138%
Tx Healthcare Foundation $66 138%
Healthsmart Preferred Care $73 153%
Independent Medical Systems $73 153%
Physician Cooperative of Texas $73 153%
Haa Preferred Partners $79 - $80 165%
San Antonio Employers Health Alliance $79 - $80 165%
Coastal Comp Health Networks $86 180%
National Healthcare Solutions $86 180%
Tml Intergovernmental Ebp $92 - $93 192%
Multiplan $99 - $113 207%
Triwest Health Alliance $99 - $100 207%
USA Managed Care $99 - $100 207%
Blue Bell $105 - $106 219%
Directcare America $105 - $106 219%
Managed Healthcare $112 - $113 234%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1139 E Sonterra Blvd,, San Antonio, TX 78258
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals