CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Garfield County Public Hospital District #1

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $59
  • Cash Discount Price: $56
  • vs. Medicare Baseline: 1.23x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Garfield County Public Hospital District #1 is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.23x the Medicare baseline. Located in 66 North Sixth Street, Pomeroy, WA.
Cash / Self-Pay
$56

Average discount available for prompt cash payment at this facility.

Insurance Median
$59

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: $56 (117%)
Insurance Median: $59 (123%)
Cash: $56 (117% of Medicare)
Ins. Median: $59 (123% 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
Cigna $53 111%
Three Rivers Provider Network - All Plans $56 117%
Aetna $59 123%
Coordinated Care - All Plans $59 123%
Premera First - All Plans $59 123%
First Choice Health Network - All Plans $59 123%
Multiplan Primary Network - All Other Plans $61 128%
Medical Cost Containment PPO - All Plans $63 132%
Multiplan Complementary $63 132%
Provider Network of America - All Plans $63 132%
Regence Blue Shield of Idaho - All Plans $66 138%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 66 North Sixth Street, Pomeroy, WA 99347
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals