CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Connecticut Childrens Medical Center

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0009
Insurance Median: $18
Cash Discount Price: $13
vs. Medicare Baseline: 0.38x Medicare

The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Connecticut Childrens Medical Center is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 0.38x the Medicare baseline. Located in 282 Washington Street, Hartford, CT.

Cash / Self-Pay

$13

Average discount available for prompt cash payment at this facility.

Insurance Median

$18

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: $13 (27%)

Insurance Median: $18 (38%)

Cash: $13 (27% of Medicare)

Ins. Median: $18 (38% 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
Multiplan [1001126]	$15 - $18	31%
UnitedHealthcare	$15 - $99	31%
Harvard Pilgrim [1001134]	$15 - $99	31%
Wellpoint [100150]	$16	33%
Aetna	$16 - $18	33%
Blue Cross Blue Shield	$16	33%
Unicare [100148]	$16	33%
Tufts Health Plan [100114]	$18	38%
1199 National Benefit Fund [100134]	$18	38%
Yale Health Plan [100162]	$18	38%
Nippon Life Ins Co of America [100112]	$18	38%
Generic Multiplan [1001130]	$18	38%
Cdphp/Comm [100199]	$18	38%
Great West Healthcare [100107]	$18	38%
Health Partners [110229]	$18	38%
Humana	$18	38%
Government Employees Hospital Assoc [100115]	$18	38%
Mvp Health Plan [100144]	$18	38%
Meritain Health [100149]	$18	38%
Cigna	$18	38%
Ultrabenefits/Comm [100181]	$18	38%
Oxford [100103]	$99	207%
Golden Rule [100106]	$99	207%

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 $13.
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 Connecticut Childrens Medical Center 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.