Pneumonia vaccine injection
Facility: Watsonville Community Hospital
Billing Code: G0009 (HCPCS)
- CPT Billing Code: G0009
- Insurance Median: $118
- Cash Discount Price: $86
- vs. Medicare Baseline: 2.47x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 247% of the Medicare baseline (a markup of 147%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicruz | $26 | 54% |
| Victim Compensation Plan | $26 - $144 | 54% |
| Aetna | $29 - $118 | 61% |
| Blue Shield HMO | $29 | 61% |
| Health Net Pmg HMO | $29 - $90 | 61% |
| Secure Horizons Dign HMO | $29 | 61% |
| Blue Cross Blue Shield | $29 - $128 | 61% |
| UnitedHealthcare | $29 - $86 | 61% |
| Pacificare HMO | $29 - $86 | 61% |
| Cigna | $29 - $101 | 61% |
| Great-West/Phcs | $29 - $101 | 61% |
| Western Growers Trust/Bc | $58 - $128 | 121% |
| Pinnacle Claims Tpa/Bc | $58 - $128 | 121% |
| Nx Health Network | $70 | 146% |
| Western Health Advantage | $72 | 151% |
| Self Pay | $86 | 180% |
| Health Net Smartcare Netw | $86 | 180% |
| Pacificare PPO | $86 | 180% |
| Health Net of California | $90 | 188% |
| Health Net Blue and Gold | $90 | 188% |
| Health Net Canopycare HMO | $90 | 188% |
| Geha (Ccn) | $101 - $115 | 211% |
| Transwestern | $101 - $115 | 211% |
| First Health | $101 - $115 | 211% |
| Adventist Risk Management | $101 - $115 | 211% |
| Private Healthcare System | $112 | 234% |
| Multiplan Inc PPO | $112 | 234% |
| Salinas Valley Mem Hops | $122 | 255% |
| Coastal Healthcare Admin | $122 - $129 | 255% |
| Calif Ironworkers Field | $125 - $128 | 261% |
| Carpenters H&W Trust | $125 - $128 | 261% |
| Claims Management Wc | $125 - $128 | 261% |
| Delta Health Systems | $125 - $128 | 261% |
| Laborers Health & Welfare | $125 - $128 | 261% |
| Monterey Bay Pub Emp Trst | $125 - $128 | 261% |
| Operating Engineers | $125 - $128 | 261% |
| Robert Kennedy/Ccn | $125 - $128 | 261% |
| Sheet Metal Workers | $125 - $128 | 261% |
| Teamsters Benefit Trust | $125 - $128 | 261% |
| City of Wats/Pinnacle Clm | $125 - $128 | 261% |
| State Compensation Fund | $125 - $128 | 261% |
| North Calif Bakery Driver | $144 | 301% |
| Physicians Mutual | $144 | 301% |
| United Administrative | $144 | 301% |
| Wholesale Beer Distributo | $144 | 301% |
| Zenith National Ins | $144 | 301% |
| Sutter Health Plus | $144 | 301% |
| Aaa | $144 | 301% |
| Travelers Insurance | $144 | 301% |
| Well Path | $144 | 301% |
| Prucare Pmg HMO | $144 | 301% |
| Aarp | $144 | 301% |
| Bankers Life & Casualty | $144 | 301% |
| Prucare Pmg POS | $144 | 301% |
| Allstate | $144 | 301% |
| Miscellaneous Insurance | $144 | 301% |
| Apwu Health Plan | $144 | 301% |
| Farmers Insurance | $144 | 301% |
| Humana | $144 | 301% |
| State Farm Ins | $144 | 301% |
| Miscellaneous Auto | $144 | 301% |