Pneumonia vaccine injection
Facility: Physicians Care Surgical Hospital
Billing Code: G0009 (HCPCS)
- CPT Billing Code: G0009
- Insurance Median: $12,568
- Cash Discount Price: $5,662
- vs. Medicare Baseline: 262.71x 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 26271% of the Medicare baseline (a markup of 26171%). 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 |
|---|---|---|
| Connecticare | $42 - $19,575 | 88% |
| Ag Administrators Inc | $52 - $23,230 | 109% |
| Trustmark | $52 - $23,230 | 109% |
| Allied Benefits Systems | $52 - $23,230 | 109% |
| Marpai Health | $52 - $23,230 | 109% |
| Premier Care Network | $52 - $23,230 | 109% |
| Healthez | $52 - $23,230 | 109% |
| Meritain Health | $52 - $23,230 | 109% |
| Allied Benefit Systems | $52 - $23,230 | 109% |
| Geha | $52 - $23,230 | 109% |
| Coventry | $52 - $23,230 | 109% |
| Aetna | $52 - $23,230 | 109% |
| Continental Benefits | $52 - $23,230 | 109% |
| Ag Administrators | $52 - $23,230 | 109% |
| Lucent Health | $52 - $23,230 | 109% |
| Blue Cross Blue Shield | $84 - $23,941 | 176% |
| Highmark | $84 - $23,941 | 176% |
| Vibra Health Plan | $1,383 - $12,772 | 2891% |
| Gpm Health and Life Insurance Mc Supplement | $1,383 - $12,772 | 2891% |
| Aarp | $1,383 - $12,772 | 2891% |
| Shenandoah Life | $1,383 - $12,772 | 2891% |
| Devon Health Services | $1,383 - $12,772 | 2891% |
| Ibc Security 65 | $1,383 - $12,363 | 2891% |
| Pcsh Aarp | $1,383 - $12,772 | 2891% |
| Cigna | $1,383 - $18,977 | 2891% |
| Medicare (plans) | $1,383 - $12,772 | 2891% |
| Keystone 65 HMO | $1,383 - $12,772 | 2891% |
| Personal Choice 65 | $1,383 - $12,363 | 2891% |
| Humana | $1,383 - $12,772 | 2891% |
| Unified Health Services | $1,383 - $12,772 | 2891% |
| Tricare | $1,383 - $12,772 | 2891% |
| UnitedHealthcare | $1,383 - $27,099 | 2891% |
| Ibc 2021 | $1,494 - $18,753 | 3123% |
| Regence Blue Shield | $1,494 - $18,753 | 3123% |
| Empire Plan | $1,494 - $18,753 | 3123% |
| Ibc | $1,494 - $18,753 | 3123% |
| Keystone Direct POS | $1,494 - $18,753 | 3123% |
| Pcsh Ibc | $1,494 - $18,753 | 3123% |
| Independence Federal | $1,494 - $18,753 | 3123% |
| Personal Choice | $1,494 - $18,753 | 3123% |
| Keystone Healthplan East | $1,494 - $18,753 | 3123% |
| Horizon of New Jersey | $1,494 - $18,753 | 3123% |
| Ibc - Local | $1,494 - $18,753 | 3123% |
| Independence Administrators | $1,494 - $18,753 | 3123% |
| Amerihealth New Jersey HMO | $1,494 - $18,753 | 3123% |
| Ibc Local | $1,494 - $18,753 | 3123% |
| Keystone HMO | $1,494 - $18,753 | 3123% |
| Carefirst Administrators | $1,494 - $18,753 | 3123% |
| Amerihealth Administrators | $1,494 - $18,753 | 3123% |
| Independence Bc | $1,494 - $18,753 | 3123% |
| Medicaid / KanCare | $2,850 | 5957% |
| Keystone First | $2,850 | 5957% |
| Keystone First Healthplan | $2,850 | 5957% |
| Straight Access | $2,850 | 5957% |
| Keystone First Vip Choice | $2,850 | 5957% |
| PA Health and Wellness | $2,850 | 5957% |
| Allsavers | $2,935 - $27,099 | 6135% |
| Oxford Life Insurance Company | $2,935 - $27,099 | 6135% |
| Golden Rule Op | $2,935 - $27,099 | 6135% |
| Surest | $2,935 - $27,099 | 6135% |
| Oxford Health Plan | $2,935 - $27,099 | 6135% |
| Health Partners | $18,977 | 39668% |
| Nalc Health | $18,977 | 39668% |
| Loomis | $18,977 | 39668% |
| Apwu | $18,977 | 39668% |
| Freedom Life Insurance Company | $18,977 | 39668% |
| Healthgram | $18,977 | 39668% |
| Sana Benefits | $18,977 | 39668% |
| Cwi Benefits | $18,977 | 39668% |
| UPMC | $19,295 | 40332% |
| Central PA Teamsters | $21,231 | 44379% |