CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Baylor Scott & White Hospital Brenham

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0009
Insurance Median: $42
Cash Discount Price: $46
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Baylor Scott & White Hospital Brenham is $42. 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 0.88x the Medicare baseline. Located in 700 Medical Parkway, Brenham, TX.

Cash / Self-Pay

$46

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: $46 (96%)

Insurance Median: $42 (88%)

Cash: $46 (96% 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.

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
Baylor Scott & White Health Plan	$9 - $33	19%
American Health Plan	$10	21%
Blue Cross Blue Shield	$10 - $166	21%
Corvel	$10	21%
Healthspring	$10	21%
Prime Health Services	$10	21%
Procare Advantage	$10	21%
Superior Health Plan	$10	21%
Triwest	$10	21%
Careworks Fka Rockport	$12	25%
Injury Management Organization	$12	25%
Sedgwick	$12	25%
UnitedHealthcare	$38	79%
Cigna	$39 - $46	82%
Aetna	$42	88%
Midcoast	$42	88%
Quiktrip	$42	88%
University of Mary Hardin-Baylor	$44	92%
Independent Medical System	$46	96%
Imagine Health	$48	100%
Curative	$50	105%
First Health	$54	113%
Healthsmart	$54 - $57	113%
Humana	$54 - $61	113%
Private Health Care System	$57	119%
Bluebell Creameries	$69	144%

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 $46.
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 Baylor Scott & White Hospital Brenham 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.