CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Kapiolani Medical Center for Women & Children

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0009
Insurance Median: $75
Cash Discount Price: $90
vs. Medicare Baseline: 1.57x Medicare

The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Kapiolani Medical Center for Women & Children is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.57x the Medicare baseline. Located in 1319 Punahou Street, Honolulu, HI.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$75

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: $90 (188%)

Insurance Median: $75 (157%)

Cash: $90 (188% of Medicare)

Ins. Median: $75 (157% 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
Ohana	$44 - $55	92%
Kaiser	$46 - $132	96%
Hmsa	$46	96%
Mdx	$46 - $120	96%
Alohacare	$46 - $51	96%
Devoted	$48	100%
UnitedHealthcare	$69	144%
Uha	$75 - $112	157%
Mimoh	$105 - $112	219%
Hwmg/Hmaa	$119	249%
Verdegard	$120	251%
Multiplan	$120 - $128	251%
Hcha	$120	251%
McCp	$128	268%
Coventry	$135	282%

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 $90.
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 Kapiolani Medical Center for Women & Children 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.