CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Saint Mary's Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$107
about 0.1× the $927 Medicare rate · typically $74–$885
modeled estimate · not a bill or quote
What this hospital charges insurers
$219
Well above the fair price
about $112 over the fair price · 0.2× Medicare
Medicare pays $927 Fair price $107 This hospital $219 Cash price $1,626 Hospital's list price $1,626

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 $143 Priciest $1,121

Black dot = this hospital, among the 9 CT hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Upper endoscopy with biopsy is about $107 (about 0.1× the $927 Medicare rate). Saint Mary's Hospital charges insurers about $219, or about $1,626 in cash — well above the fair price. Located in Waterbury, CT.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $107. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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 $82 - $1,066 9%
Blue Cross Blue Shieldmajor $82 - $3,225 9%
Aetnamajor $82 - $1,066 9%
Cignamajor $82 - $1,098 9%
Humanamajor $82 - $219 9%
Kaiser Permanentemajor $238 - $3,225 26%
Ambetter (Centene) $82 - $105 9%
Clover Health $105 - $219 11%
Harvard Pilgrim $256 - $411 28%
Health Net $82 - $491 9%
HealthPartners $82 - $105 9%
Meridian $82 - $219 9%
Molina $82 - $105 9%
Paramount $82 - $105 9%
Presbyterian $82 - $219 9%
Tufts Health Plan $82 - $409 9%
UniCare $169 - $3,225 18%
WellMed $105 - $219 11%
WellSense $82 - $105 9%
+ 357 smaller / regional plans $82 - $3,225
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 12 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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.

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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