CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Coastal Carolina Hospital

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0009
Insurance Median: $70
Cash Discount Price: $80
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Coastal Carolina Hospital is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.46x the Medicare baseline. Located in 1000 Medical Center Drive, Hardeeville, SC.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$70

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: $80 (167%)

Insurance Median: $70 (146%)

Cash: $80 (167% of Medicare)

Ins. Median: $70 (146% 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	$27 - $72	56%
Molina	$32 - $72	67%
Humana	$32 - $44	67%
Select Health	$32 - $83	67%
Absolute Total Care	$34 - $72	71%
Devoted Health	$44	92%
Aetna	$44 - $130	92%
Cigna	$45 - $81	94%
Clover Insurance Company	$45	94%
Blue Cross Blue Shield	$65 - $125	136%
Medcost - Sc	$124 - $131	259%
Plotkin Health	$147 - $155	307%
PHCS	$220 - $233	460%
Multiplan	$220 - $233	460%

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 $80.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0009.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Coastal Carolina Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0009.
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.