Pneumonia vaccine injection
Facility: Ohio Valley Surgical Hospital
Billing Code: G0009 (HCPCS)
- CPT Billing Code: G0009
- Insurance Median: $4,022
- Cash Discount Price: $77
- vs. Medicare Baseline: 84.07x 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 8407% of the Medicare baseline (a markup of 8307%). 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 |
|---|---|---|
| Mhbp | $12 - $20,896 | 25% |
| Aetna | $12 - $20,896 | 25% |
| Pacific Source | $12 - $20,896 | 25% |
| Ngs Coresource | $12 - $20,896 | 25% |
| Personify Health | $12 - $20,896 | 25% |
| Nippon Life | $12 - $20,896 | 25% |
| Geha | $12 - $20,896 | 25% |
| Mail Handlers | $12 - $20,896 | 25% |
| Genworth | $12 - $20,896 | 25% |
| Meritain | $12 - $20,896 | 25% |
| Meritain Heatlh | $12 - $20,896 | 25% |
| Molina McR McD | $44 - $11,885 | 92% |
| Bankers Fidelity | $44 - $11,885 | 92% |
| Prosperity Supplement | $44 - $11,885 | 92% |
| Blue Cross Blue Shield | $44 - $40,293 | 92% |
| Molina Dual McR | $44 - $11,885 | 92% |
| Gateway Health Plan | $44 - $11,885 | 92% |
| Self Pay Imaging | $44 - $11,885 | 92% |
| Molina McR | $44 - $11,885 | 92% |
| American Continental Insurance | $44 - $11,885 | 92% |
| Molina Marketplace | $44 - $11,885 | 92% |
| Molina Dual McR | $44 - $11,885 | 92% |
| Wellcare By Allwell | $44 - $11,885 | 92% |
| Cigna | $44 - $18,817 | 92% |
| American Republic | $44 - $11,885 | 92% |
| UnitedHealthcare | $44 - $17,571 | 92% |
| Medicare (plans) | $44 - $12,264 | 92% |
| Wraparound Pl Supp | $44 - $11,885 | 92% |
| Medigold | $44 - $11,885 | 92% |
| Champus | $44 - $11,885 | 92% |
| Molina McR+McD | $44 - $11,885 | 92% |
| Everest | $44 - $11,885 | 92% |
| Aarp Supplemental | $44 - $11,885 | 92% |
| Aultcare Primetime Health Plan | $44 - $11,885 | 92% |
| Humana | $44 - $11,919 | 92% |
| Patient No Pay | $44 - $11,885 | 92% |
| Communicare Advantage | $44 - $11,885 | 92% |
| Bankers Life and Casualty | $44 - $11,885 | 92% |
| American Retirement | $44 - $11,885 | 92% |
| Molina | $44 - $11,885 | 92% |
| Mmoh | $44 - $11,885 | 92% |
| Central States | $44 - $11,885 | 92% |
| American Continental Life | $44 - $11,885 | 92% |
| Aarp | $44 - $11,885 | 92% |
| The Health Plan | $46 - $12,479 | 96% |
| Devoted Health | $48 - $13,707 | 100% |
| Employer Direct | $51 - $15,703 | 107% |
| Mmoh (Supermed) | $59 - $60 | 123% |
| Mmo Cin. HMO | $59 - $81 | 123% |
| Medicaid / KanCare | $66 - $17,827 | 138% |
| Caresource | $66 - $17,827 | 138% |
| Caresourse | $66 - $17,827 | 138% |
| Healthgram | $71 - $18,817 | 148% |
| Samba | $71 - $18,817 | 148% |
| Unified Group | $71 - $18,817 | 148% |
| Nalc | $71 - $18,817 | 148% |
| Sbma | $71 - $18,817 | 148% |
| Preferred Health | $115 | 240% |
| Luminare Health | $115 | 240% |
| Ohio Health | $115 | 240% |
| Medben | $115 | 240% |
| Amerihealth Caritas of Ohio | $3,657 | 7644% |
| Buckeye Community Health Plan | $4,022 | 8407% |
| Molina McD | $4,084 | 8537% |
| Surest | $17,571 | 36729% |
| Ushealth | $17,571 | 36729% |
| Oxford | $17,571 | 36729% |
| Golden Rule | $17,571 | 36729% |
| Medica | $17,571 | 36729% |
| Shl | $17,571 | 36729% |