Office visit, established patient (20-29 min)
Facility: Saint Mary's Hospital
Billing Code: 99213 (CPT)
This hospital's typical commercial price is $43 compared to the $72 fair price benchmark.
3-Star CMS clinical quality rating paired with 0.60× fair market pricing.
One of the lower prices — 7 of 8 other CT hospitals charge more for the same procedure.
Black dot = this hospital, among the 9 CT hospitals with a price for this procedure. Full list below.
A fair price for a Office visit, established patient (20-29 min) is about $72 (about 0.8× the $95 Medicare rate). Saint Mary's Hospital charges insurers about $43 — below the fair price — a good deal. Located in Waterbury, CT.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
6 of 6 major insurers have a published price at this hospital
Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.
| Insurance company | Price range | vs. Medicare |
|---|---|---|
| UnitedHealthcaremajor | $10 - $7,184 | 11% |
| Blue Cross Blue Shieldmajor | $10 - $756 | 11% |
| Aetnamajor | $15 - $250 | 16% |
| Cignamajor | $43 - $9,628 | 45% |
| Humanamajor | $10 - $64 | 11% |
| Kaiser Permanentemajor | $10 - $756 | 11% |
| Ambetter (Centene) | $43 | 45% |
| Clover Health | $59 | 62% |
| GEHA | $7,184 | 7547% |
| Harvard Pilgrim | $22 - $7,184 | 23% |
| Health Net | $15 - $96 | 16% |
| HealthPartners | $43 - $9,628 | 45% |
| MagnaCare | $9,628 | 10115% |
| Meridian | $43 - $59 | 45% |
| Molina | $43 | 45% |
| Paramount | $43 | 45% |
| Presbyterian | $43 - $59 | 45% |
| Tufts Health Plan | $22 - $137 | 23% |
| UniCare | $17 - $756 | 18% |
| WellMed | $59 | 62% |
| WellSense | $43 | 45% |
| + 362 smaller / regional plans | $10 - $9,628 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Saint Mary's Hospital
Compare: Office visit, established patient (20-29 min) at other CT hospitals
- Johnson Memorial Hospital · Stafford Springs $31
- Hartford Hospital · Hartford $60
- The Hospital of Central Connecticut · New Britain $60
- Bristol Hospital · Bristol $70
- Greenwich Hospital Association - · Greenwich $75
- Natchaug Hospital · Mansfield Center $83
- St Francis Hospital & Medical Center · Hartford $98
- Gaylord Hospital · Wallingford $100
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Saint Mary's Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $51
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $51).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Saint Mary's Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $72 Fair BaseRate ($95 Medicare)
Your bill ($140) is $68 above the denoised Fair BaseRate ($72) and 1.5× the $95 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.