CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Charleston Area Medical Center

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $75
  • Cash Discount Price: $94
  • vs. Medicare Baseline: 1.57x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Charleston Area Medical Center is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.57x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.
Cash / Self-Pay
$94

Average discount available for prompt cash payment at this facility.

Insurance Median
$75

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: $94 (196%)
Insurance Median: $75 (157%)
Cash: $94 (196% of Medicare)
Ins. Median: $75 (157% 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
Aetna $9 - $92 19%
Optimum Choice Inc. $38 79%
Unicare Health Plan of West Virginia Inc. $45 - $70 94%
The Health Plan of West Virginia Inc. $45 - $91 94%
Triwest VA $46 - $71 96%
Blue Cross Blue Shield $48 - $86 100%
Choicecare Network $48 - $92 100%
UnitedHealthcare $49 - $92 102%
West Virginia Senior Advantage Inc. $50 - $77 105%
Tricare $56 117%
City of Charleston $70 146%
Integrated Medical Solutions $85 178%
Cigna $87 182%
Three Rivers Providers Network $91 190%
Multiplan $92 192%
Healthsmart $92 192%
Caresource $94 196%
Naphcare $94 196%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 501 Morris Street, Charleston, WV 25301
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals