CMS Price Transparency Data

Pneumonia vaccine injection

Facility: Univ. of Vermont - Fletcher Allen Health Care

Billing Code: G0009 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0009
Insurance Median: $51
Cash Discount Price: $68
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Pneumonia vaccine injection at Univ. of Vermont - Fletcher Allen Health Care is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.07x the Medicare baseline. Located in 111 Colchester Ave, Burlington, VT.

Cash / Self-Pay

$68

Average discount available for prompt cash payment at this facility.

Insurance Median

$51

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: $68 (142%)

Insurance Median: $51 (107%)

Cash: $68 (142% of Medicare)

Ins. Median: $51 (107% 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
Mvp	$10 - $51	21%
UnitedHealthcare	$23 - $137	48%
Veterans Affairs Community Care Network	$28	59%
Capital District Physicians' Health Plan	$33 - $65	69%
Martins Point	$33	69%
Wellpath	$37	77%
Blue Cross Blue Shield	$38 - $52	79%
Cigna	$51	107%
Ebpa	$52	109%
Harvard Pilgrim	$54	113%
Magnacare	$54	113%
St. Regis	$54	113%
Coventry	$58	121%
Nppn	$61	128%

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 $68.
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 Univ. of Vermont - Fletcher Allen Health Care 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.