CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Ira Davenport Memorial Hospital

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0009
  • Insurance Median: $45
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Ira Davenport Memorial Hospital is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 0.94x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.
Cash / Self-Pay
$32

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: $32 (67%)
Insurance Median: $45 (94%)
Cash: $32 (67% 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 $15 - $196 31%
Empire $27 - $32 56%
Fidelis Care - Exchange - All Plans $28 - $35 59%
Geisinger - All Plans $29 - $38 61%
Mvp Health Plan - All Plans $31 - $40 65%
Cigna $31 - $40 65%
Independent Health - All Plans $32 - $42 67%
UPMC - All Plans $34 - $44 71%
Pomco Inc - All Plans $36 - $46 75%
Aetna $38 - $58 79%
Emblem Health - All Plans $44 - $57 92%
Humana $45 - $58 94%
Emblem/Ghi $46 - $60 96%
Martins Point - All Plans $50 - $64 105%
Fidelis $50 105%
UnitedHealthcare $52 - $68 109%
Tricare $55 115%
Amerihealth Caritas McR Adv - All Plans $55 115%
Healthnow - All Plans $165 - $212 345%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7571 State Route 54, Bath, NY 14810
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Rural Emergency Hospital