Pneumonia vaccine injection
Facility: Hackensack Meridian Mountainside Medical
Billing Code: G0009 (HCPCS)
- CPT Billing Code: G0009
- Insurance Median: $132
- Cash Discount Price: $60
- vs. Medicare Baseline: 2.76x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 276% of the Medicare baseline (a markup of 176%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Healthscope Benefits [2290] | $16 - $132 | 33% |
| UnitedHealthcare | $16 | 33% |
| Aetna | $24 - $137 | 50% |
| Medicare (plans) | $64 | 134% |
| Wtc Healthcare Sme Karna [8005] | $64 | 134% |
| Create Flex / Select [3580] | $64 | 134% |
| Lucent Health [6000] | $64 | 134% |
| Healthcare Highways [2210] | $64 - $132 | 134% |
| Selecthealth [3740] | $64 | 134% |
| Web Tpa [2115] | $64 - $137 | 134% |
| Worker's Comp [2125] | $64 | 134% |
| Black Lung [6055] | $64 | 134% |
| Oncology Patient Assistance Programs [2295] | $64 | 134% |
| First Health [1375] | $117 - $132 | 245% |
| Multiplan [1680] | $132 | 276% |
| Hometown Health [2155] | $132 | 276% |
| Planned Administrators Inc [2360] | $132 | 276% |
| Trustmark [2030] | $132 | 276% |
| Pba [1775] | $132 | 276% |
| PHCS [1780] | $132 | 276% |
| Administrative Concepts [1005] | $132 | 276% |
| Resource One Administrators [2815] | $132 | 276% |
| Pan American Life Insurance Co [1770] | $132 | 276% |
| Mayo Clinic Health Solutions [2280] | $132 | 276% |
| Healthcost Solutions [2415] | $132 | 276% |
| Mutual of Omaha [1685] | $132 | 276% |
| Healthfirst [2395] | $132 | 276% |
| Gilsbar [1425] | $132 | 276% |
| New Era Life Insurance Company [1705] | $132 | 276% |
| Universal Fidelity [2085] | $132 | 276% |
| Healthnet [1495] | $132 | 276% |
| Allied National Global Care [1035] | $132 | 276% |
| 1199 Seiu Benefit Fund [3505] | $137 | 286% |
| Allied Benefit Systems Inc [1030] | $137 | 286% |
| Meritain Health [1655] | $137 | 286% |
| Mvp Health Plan [2180] | $151 | 316% |
| National Association of Letter Carriers [1695] | $151 | 316% |
| Cigna | $151 | 316% |
| Samba Health [2305] | $151 | 316% |
| Amerihealth [3520] | $155 | 324% |
| Mva [1690] | $155 | 324% |