CMS Price Transparency Data

Flu vaccine injection

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: G0008 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0008
Insurance Median: $17
Cash Discount Price: $12
vs. Medicare Baseline: 0.36x Medicare

The contracted insurance negotiated median rate for a Flu vaccine injection at UPMC Children's Hospital of Pittsburgh is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 0.36x the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$12

Average discount available for prompt cash payment at this facility.

Insurance Median

$17

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: $12 (25%)

Insurance Median: $17 (36%)

Cash: $12 (25% of Medicare)

Ins. Median: $17 (36% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
UnitedHealthcare	$8 - $40	17%
Aetna	$8 - $48	17%
Geisinger	$9 - $41	19%
Cigna	$9 - $48	19%
Health Plan of Upper Ohio Valley	$13 - $44	27%
Intergroup	$13 - $17	27%
Coventry/First Health	$16	33%
Saudi Armed Forces	$16	33%
Health Payors Organization	$17	36%
Multiplan	$17	36%
Private Health Care Systems	$18	38%
National Provider Network	$18	38%
Blue Cross Blue Shield	$21 - $47	44%
UPMC Health Plan	$23 - $53	48%
Amerihealth Caritas	$37 - $48	77%
Health Partners Plans (Jefferson Health Plan)	$39	82%
Highmark Wholecare (Prev Gateway)	$40	84%
PA Health & Wellness	$41	86%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $12.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0008.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Children's Hospital of Pittsburgh is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0008.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.