CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Baylor Scott & White Medical Center- Austin

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $45
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Baylor Scott & White Medical Center- Austin is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 0.94x the Medicare baseline. Located in 5245 W Us 290, Austin, TX.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$45

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: $46 (96%)
Insurance Median: $45 (94%)
Cash: $46 (96% of Medicare)
Ins. Median: $45 (94% 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 Plan $22 - $42 46%
Baylor Scott & White Health Plan $28 - $70 59%
Cigna $36 - $42 75%
UnitedHealthcare $38 - $49 79%
Aetna $42 88%
Humana $42 - $54 88%
Midcoast $42 88%
Quiktrip $42 88%
Triwest $42 88%
University of Mary Hardin-Baylor $44 92%
American Health Plan $45 94%
Healthspring $45 94%
Procare Advantage $45 94%
Curative $50 105%
First Health $54 113%
Private Health Care System $57 119%
Blue Cross Blue Shield $136 - $166 284%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5245 W Us 290, Austin, TX 78735
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals