CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Brattleboro Memorial Hospital

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0009
Insurance Median: $67
Cash Discount Price: $55
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Brattleboro Memorial Hospital is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.40x the Medicare baseline. Located in 17 Belmont Ave, Brattleboro, VT.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

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: $55 (115%)

Insurance Median: $67 (140%)

Cash: $55 (115% of Medicare)

Ins. Median: $67 (140% 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
Blue Cross Blue Shield	$22 - $70	46%
Vermont Health Plan	$25 - $70	52%
Martin's Point	$44	92%
Harvard Pilgrim Health Care	$44 - $68	92%
UnitedHealthcare	$44 - $74	92%
Humana	$44	92%
Mvp Healthcare	$44 - $70	92%
New Hampshire Healthy Families (Wellcare)	$46	96%
Cigna	$46 - $74	96%
Wellsense	$47	98%
Multiplan	$53 - $76	111%
Aetna	$55 - $76	115%
Coventry	$55 - $76	115%
Tufts Health Plan	$60 - $71	125%
Health New England	$76	159%

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 $55.
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 Brattleboro Memorial Hospital 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.