CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Medical City Alliance

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0009
Insurance Median: $41
Cash Discount Price: $140
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Medical City Alliance is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 0.86x the Medicare baseline. Located in 3101 North Tarrant Parkway, Fort Worth, TX.

Cash / Self-Pay

$140

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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: $140 (293%)

Insurance Median: $41 (86%)

Cash: $140 (293% of Medicare)

Ins. Median: $41 (86% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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 Plan	$10	21%
Aetna	$19 - $102	40%
Cigna	$19 - $52	40%
Oscar	$29	61%
United	$32	67%
Healthcare Highways	$34 - $47	71%
Evry Health	$36	75%
Curative Administrators	$56	117%
Blue Cross Blue Shield	$62 - $256	130%
Multiplan PHCS	$98	205%
Healthsmart Preferred Care	$105	219%
Independent Medical Systems	$140	293%
National Healthcare Solutions	$140	293%
Humana	$142	297%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $140.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0009.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Medical City Alliance is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0009.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.