Waterbury Hospital
Waterbury Hospital in Waterbury, CT charges 5.2x the Medicare reimbursement rate on average across 50 analyzed procedures, reflecting the pricing patterns at this for-profit facility.
Waterbury, CT 06721 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
David Park researches procedure pricing and insurance reimbursement patterns at BillRazor Research. He specializes in cost comparison across care settings and metropolitan areas. Expertise: procedure pricing, insurance reimbursement, cost comparison.
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Billing patterns — for-profit
For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.
Pricing grade
D
High
Avg markup vs Medicare
5.23x
Charge / Medicare rate
Max markup
9.63x
Worst procedure
Procedures analyzed
50
With pricing data
Outlier procedures
0%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $60,305 | $30,153 | — | 9.6x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $58,511 | $29,256 | — | 7.6x |
| HYPERTENSION WITHOUT MCC | 305 | $39,625 | $19,813 | — | 7.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $37,018 | $18,509 | — | 7x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $98,577 | $49,288 | — | 7x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $71,469 | $35,735 | — | 7x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $140,945 | $70,473 | — | 6.9x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $71,805 | $35,902 | — | 6.5x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $37,588 | $18,794 | — | 6.1x |
| DIABETES WITH CC | 638 | $43,260 | $21,630 | — | 6x |
| RENAL FAILURE WITH CC | 683 | $40,530 | $20,265 | — | 5.9x |
| DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | 441 | $87,814 | $43,907 | — | 5.9x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | 243 | $119,834 | $59,917 | — | 5.9x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $44,726 | $22,363 | — | 5.8x |
| SYNCOPE AND COLLAPSE | 312 | $39,991 | $19,996 | — | 5.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $37,798 | $18,899 | — | 5.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $63,946 | $31,973 | — | 5.7x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $52,334 | $26,167 | — | 5.7x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $66,146 | $33,073 | — | 5.6x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $75,134 | $37,567 | — | 5.4x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $39,593 | $19,797 | — | 5.3x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $33,017 | $16,509 | — | 5.2x |
| OTHER FACTORS INFLUENCING HEALTH STATUS | 951 | $23,882 | $11,941 | — | 5.1x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $31,227 | $15,613 | — | 5x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $85,892 | $42,946 | — | 5x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $84,033 | $42,017 | — | 4.9x |
| RENAL FAILURE WITH MCC | 682 | $57,967 | $28,984 | — | 4.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $40,502 | $20,251 | — | 4.9x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $106,535 | $53,267 | — | 4.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $81,698 | $40,849 | — | 4.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $270,892 | $135,446 | — | 4.7x |
| SEIZURES WITHOUT MCC | 101 | $32,645 | $16,323 | — | 4.7x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $43,839 | $21,920 | — | 4.6x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $65,947 | $32,973 | — | 4.6x |
| CELLULITIS WITHOUT MCC | 603 | $32,258 | $16,129 | — | 4.6x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $38,924 | $19,462 | — | 4.5x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $215,701 | $107,851 | — | 4.5x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $48,942 | $24,471 | — | 4.4x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $68,946 | $34,473 | — | 4.4x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $27,623 | $13,812 | — | 4.4x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $63,112 | $31,556 | — | 4.3x |
| DIABETES WITH MCC | 637 | $47,819 | $23,910 | — | 4.1x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $38,426 | $19,213 | — | 4x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $66,200 | $33,100 | — | 4x |
| RESPIRATORY NEOPLASMS WITH MCC | 180 | $49,708 | $24,854 | — | 3.9x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $35,278 | $17,639 | — | 3.8x |
| SEIZURES WITH MCC | 100 | $59,781 | $29,891 | — | 3.7x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $36,482 | $18,241 | — | 3.5x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $78,112 | $39,056 | — | 3.4x |
| POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | 917 | $43,705 | $21,852 | — | 3.3x |
How WATERBURY HOSPITAL compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use