CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Saint Mary's Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$70
about 0.7× the $95 Medicare rate · typically $38–$90
modeled estimate · not a bill or quote
What this hospital charges insurers
$43
Below the fair price — a good deal
about $27 under the fair price · 0.5× Medicare
Medicare pays $95 Fair price $70 This hospital $43 Hospital's list price $140

How we calculate the fair BaseRate →

How this hospital compares to other CT hospitals

One of the lower prices — 7 of 8 other CT hospitals charge more for the same procedure.

Cheapest $31 Priciest $106

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 $70 (about 0.7× 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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

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
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 14 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals