CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Mount Sinai Rehabilitation Hospital Inc

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $138
  • Cash Discount Price: $95
  • vs. Medicare Baseline: 2.88x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Mount Sinai Rehabilitation Hospital Inc is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 2.88x the Medicare baseline. Located in 490 Blue Hills Ave, Hartford, CT.
Cash / Self-Pay
$95

Average discount available for prompt cash payment at this facility.

Insurance Median
$138

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: $95 (199%)
Insurance Median: $138 (288%)
Cash: $95 (199% of Medicare)
Ins. Median: $138 (288% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 288% of the Medicare baseline (a markup of 188%). 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.

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 $54 - $172 113%
Aetna $54 - $139 113%
Medicare (plans) $54 - $56 113%
UnitedHealthcare $54 - $172 113%
Cigna $55 - $155 115%
Cca Senior Care Options $55 115%
Health New England $91 190%
Innovative Health Plan II $115 240%
Claimdoc $115 240%
Diversified Administrators $115 240%
PHCS $117 245%
Paramount HMO $117 245%
Allied National Global Care $117 245%
Trinity Health Share $117 245%
Family Life Insurance Company $117 245%
Asrm - Reliance Standard Life Insurance $117 245%
Christian Care Ministry $117 245%
Pai $117 245%
Mvp $117 245%
Lifetime Benefit Solutions $117 245%
Manhattan Life $117 245%
Pan-American Life $117 245%
Multiplan $117 245%
International Benefit Administrators $117 245%
Ghc Scw $117 245%
Dean Health $117 245%
Medi Share $117 245%
Prime Health Services $138 288%
Allied Benefit Systems $139 291%
Meritain $139 291%
Luminare Health $139 291%
Hap $139 291%
Nippon Life Ins $139 291%
Webtpa $139 291%
Gravie Admin Services $139 291%
1199 National Benefit Fund $139 291%
Connecticare $140 - $155 293%
Health Smart $146 305%
Allegiance $155 324%
Magnacare $155 324%
Health Partners $155 324%
Blue Shield - PA (Highmark) $172 360%
Blue Shield - Ny Highmark Northeastern $172 360%
Pre-Employment $172 360%
Unicare $172 360%
Kaiser Domestic $172 360%
Blue Shield - Id (Regence) $172 360%
Blue Shield - Ca $172 360%
Harvard Pilgrim Healthcare $172 360%
Blue Benefit Administrators of Massachusetts $172 360%
Blue Care Network $172 360%
Geha $172 360%
Blue Shield - Wa (Regence) $172 360%
Wc Domestic $172 360%
Blue Distinction Transplant $172 360%
Blue Shield - Ny Highmark Western $172 360%
Health Choices $172 360%
Bcn Domestic $172 360%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 490 Blue Hills Ave, Hartford, CT 06112
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL