CMS Price Transparency Data

Pneumonia vaccine injection

Facility: HCA Florida Osceola Hospital

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $38
  • Cash Discount Price: $163
  • vs. Medicare Baseline: 0.79x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at HCA Florida Osceola Hospital is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 0.79x the Medicare baseline. Located in 700 West Oak Street, Kissimmee, FL.
Cash / Self-Pay
$163

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $163 (341%)
Insurance Median: $38 (79%)
Cash: $163 (341% of Medicare)
Ins. Median: $38 (79% 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
Optimum $8 - $14 17%
Freedom Health $8 - $14 17%
Truli for Health $9 - $17 19%
Avmed $9 - $97 19%
Blue Cross Blue Shield $10 - $39 21%
Oscar $17 - $31 36%
Simply $17 - $30 36%
Simply Healthcare $18 - $32 38%
Cigna $19 - $34 40%
Molina Healthcare $21 - $52 44%
Aetna $22 - $58 46%
Evolutions $25 - $45 52%
Sunshine State Health Plan $28 - $50 59%
Humana $31 - $54 65%
United $36 - $87 75%
Prime Health Sheriff $55 - $97 115%
Plotkin Health $55 - $97 115%
Corvel Corporation $68 142%
Prime Health $70 146%
Careworks (Rockport Community) $72 151%
Multiplan $82 - $165 171%
Evernorth $87 - $155 182%
PPO Next $93 - $165 194%
Novanet $98 - $175 205%
Beacon Health Options $109 - $194 228%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 700 West Oak Street, Kissimmee, FL 34741
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals