CMS Price Transparency Data

Pneumonia vaccine injection

Facility: HCA Florida Fort Walton-Destin Hospital

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $45
  • Cash Discount Price: $110
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at HCA Florida Fort Walton-Destin Hospital is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 0.94x the Medicare baseline. Located in 1000 Mar-Walt Dr, Fort Walton Beach, FL.
Cash / Self-Pay
$110

Average discount available for prompt cash payment at this facility.

Insurance Median
$45

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: $110 (230%)
Insurance Median: $45 (94%)
Cash: $110 (230% of Medicare)
Ins. Median: $45 (94% 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
Blue Cross Blue Shield $12 - $28 25%
Oscar $14 29%
Simply $17 36%
Simply Healthcare $18 38%
Cigna $19 - $46 40%
Molina Healthcare $21 - $35 44%
United $23 - $50 48%
Avmed $26 - $55 54%
Sunshine State Health Plan $28 59%
Aetna $32 - $45 67%
Humana $42 88%
Prime Health Sheriff $55 115%
Plotkin Health $55 115%
Corvel Corporation $69 144%
Prime Health $70 146%
Evolutions Healthcare $72 - $99 151%
Naphcare $72 151%
Careworks (Rockport Community) $73 153%
Multiplan $86 - $94 180%
Evernorth $88 184%
PPO Next $94 196%
Novanet $99 207%
Beacon Health Options $110 230%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Mar-Walt Dr, Fort Walton Beach, FL 32547
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals