CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Atlanticare Regional Medical Center - City Campus

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $121
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.53x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Atlanticare Regional Medical Center - City Campus is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 2.53x the Medicare baseline. Located in 1925 Pacific Avenue, Atlantic City, NJ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$121

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%)
Insurance Median: $121 (253%)
Ins. Median: $121 (253% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 253% of the Medicare baseline (a markup of 153%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Americhoice $18 - $24 38%
UnitedHealthcare $18 - $132 38%
Horizon $19 - $130 40%
Wellcare $19 - $26 40%
Self Pay $21 - $28 44%
Amerigroup $36 - $48 75%
Tricare $46 96%
Devoted Health Plan $54 113%
Magnacare $55 - $167 115%
Cigna $58 - $94 121%
Qualcare Commercial $69 - $93 144%
Evernorth $69 - $93 144%
Great West Life $70 - $94 146%
Global Exchange Managed Care $79 165%
Aetna $79 - $154 165%
Amerihealth $89 - $156 186%
Active Care Plus $90 - $121 188%
Qualcare Wc $90 - $121 188%
First McO $90 - $121 188%
Mutual of Omaha $90 - $121 188%
Donio Trucking $97 - $130 203%
Consumer Health Network (Chn) $97 - $167 203%
Oxford $104 - $140 217%
Devon/ Ullicare $104 - $140 217%
Health Partners Plan $105 219%
Coventry Health Care $110 - $149 230%
Private Healthcare System (PHCS) $110 - $149 230%
Blue Cross Blue Shield $114 - $153 238%
Health South $117 - $158 245%
Three Rivers Provider Network (Trpn) $117 - $158 245%
Health Payors Org $117 - $158 245%
Prime Health Services $117 - $158 245%
Metrahealth of Nj $117 - $158 245%
Intergroup Preferred Program $124 - $167 259%
Metracomp $124 - $167 259%
Provider Select, Inc $124 - $167 259%
McS Commercial $124 - $167 259%
Health Network Inc $124 - $167 259%
Department of Corrections $124 - $167 259%
Choice Care $124 - $167 259%
Beech Street $124 - $167 259%
Galaxy Health Network $124 - $167 259%
Multiplan $124 - $167 259%
Active Care Nj Pip $124 - $167 259%
Master Care Inc $128 - $172 268%
Atlantis Health Plan $128 - $172 268%
National Health Plan $131 - $177 274%
Health Network America $131 - $177 274%
McSi/Mrsi Worker's Comp $131 - $177 274%
Advance Healthcare System $131 - $177 274%
Community Care Network $131 - $177 274%
McSi/Mrsi No Fault $131 - $177 274%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1925 Pacific Avenue, Atlantic City, NJ 08401
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals