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Short Term Acute Care HospitalProprietary

Pmh - Waterbury Hospital

Prospect Medical Holdings · Waterbury, CT

64 Robbins Street, Waterbury, CT 06708(203) 573-6000

2 of 5

CMS star rating

258

Beds

8,026

Inpatient discharges a year

$222.5M

Net patient revenue a year

29

In-network payers

About this hospital

Pmh - Waterbury Hospital is a 258-bed proprietary hospital in Waterbury, CT, affiliated with Prospect Medical Holdings. Below you'll find publicly disclosed negotiated rates and facility details, including 29 in-network payers and 280 disclosed rate categories.

  • Disproportionate share hospital
CCN
070005
NPI
1477902641
Health system
Prospect Medical Holdings
Teaching
Teaching hospital
County
New Haven County
Metro area
New Haven-Milford, CT MSA
Medicare contractor
Jurisdiction K, National Government Services (13001)
In Medicare since
1966
Last CMS survey
2016

Prices for common services

The 24 services Pmh - Waterbury Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.

Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.

Childbirth · Inpatient

Vaginal delivery, hospital stay

MS-DRG 807

$6,210 - $12,784

from 4 insurers · median $12,268

Cigna$12,769
Insurer A*$6,210
Insurer B*$11,767
Insurer C*$12,784

CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.

Hospital reports neonatal nursery services to CMS

Childbirth · Inpatient

Cesarean delivery, hospital stay

MS-DRG 788

$9,164 - $17,313

from 4 insurers · median $16,918

Cigna$16,741
Insurer A*$9,164
Insurer B*$17,096
Insurer C*$17,313

CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.

Hospital reports neonatal nursery services to CMS

Medicine & Surgery · Inpatient

Major cardiothoracic procedure with cardiac catheterization and MCC

MS-DRG 216

$50,176 - $190,852

from 4 insurers · median $167,903

Aetna$165,066
Insurer A*$50,176
Insurer B*$170,739
Insurer C*$190,852
Medicare $90,833Nearby hospitals $194,30514% below nearby hospitals

Hospital reports cardiac thoracic surgery services to CMS

Childbirth · Inpatient

Vaginal birth after prior cesarean, hospital stay

MS-DRG 807

$6,210 - $12,784

from 4 insurers · median $12,268

Cigna$12,769
Insurer A*$6,210
Insurer B*$11,767
Insurer C*$12,784

CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.

Hospital reports neonatal nursery services to CMS

How the insurers pay at Pmh - Waterbury Hospital

Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.

InsurerServicesMedian % of MedicareAbove nearbyBelow nearby
Insurer A*23
311%
87
Insurer B*24
280%
811
Insurer C*20
265%
411
Insurer D*24
182%
87

How we chose these services: 4 appear in this hospital's own Medicare claims, 13 are common here based on CMS Medicare volume, and 7 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Pmh - Waterbury Hospital, or start a free trial.

Insurance Accepted

Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.

Medicare
Aetna
BCBS
Cigna
United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health)
Ameri HealthAspirus Health PlanAvera Health PlansBanner HealthEMI HealthEmblemHealth

More about this hospital

  • Quality

    2 of 5 stars

    • 227 min in the ER before going home (US median 148)
    • Medicare readmissions penalty (-0.37%)
    See quality ratings
  • Doctors and services

    Accredited by The Joint Commission

    • Teaching hospital
    • 42 services, including trauma care
    • 362 affiliated clinicians
    See doctors and services
  • Finances

    $222.5M net patient revenue

    • Operating margin on patient care -23.8%
    • $23.3M unreimbursed and uncompensated care
    • -$48.3M net income
    See finances
  • Ownership and leadership

    Owned by Chamber Inc

    • Private (for profit)
    • Justin Lundbye, chief executive
    See ownership and leadership

Tax IDs and NPIs insurers list

The employer identification numbers (EINs) health plans and networks list for Pmh - Waterbury Hospital in the in-network rate files they publish, with the organization NPIs billed under each.

Tax ID (EIN)Plans and networks listing itOrganization NPIs
81-2181470Prospect Waterbury INC46Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Aspirus Health Plan and 41 more1477902641 Prospect Waterbury Inc.1184615114 Waterbury Hospital1306704028 Waterbury Health Operations Corp.and 1 more

Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.

Location

64 Robbins Street, Waterbury, CT 06708

(203) 573-6000

Get directions

Frequently asked questions

About Pmh - Waterbury Hospital's rates and hospital price transparency.

How much does an MRI cost at Pmh - Waterbury Hospital?

For MRI brain before and after contrast (CPT 70553), published negotiated rates at Pmh - Waterbury Hospital range from $639 to $1,612 across 4 insurers. Blue Cross Blue Shield's rate is $1,612. The median at nearby comparable hospitals is $594. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a CT scan cost at Pmh - Waterbury Hospital?

For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Pmh - Waterbury Hospital range from $267 to $2,025 across 4 insurers. UnitedHealthcare's rate is $663. The median at nearby comparable hospitals is $650. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a colonoscopy cost at Pmh - Waterbury Hospital?

For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Pmh - Waterbury Hospital range from $3,378 to $4,647 across 4 insurers. Blue Cross Blue Shield's rate is $4,639. The median at nearby comparable hospitals is $3,906. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does giving birth cost at Pmh - Waterbury Hospital?

For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Pmh - Waterbury Hospital range from $6,210 to $12,784 across 4 insurers. Cigna's rate is $12,769. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a mammogram cost at Pmh - Waterbury Hospital?

For Screening mammography, bilateral (CPT 77067), published negotiated rates at Pmh - Waterbury Hospital range from $169 to $483 across 4 insurers. Aetna's rate is $483. The median at nearby comparable hospitals is $232. What a patient pays depends on their plan's deductible, coinsurance and network status.

What is Pmh - Waterbury Hospital's CMS star rating?

Pmh - Waterbury Hospital has a CMS overall hospital star rating of 2 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is lower than 73% of US hospitals.

Is Pmh - Waterbury Hospital a teaching hospital?

Yes. CMS counts 0.20 Medicare-funded residents per bed at Pmh - Waterbury Hospital for fiscal year 2027, so it is a teaching hospital.

Does Medicare penalize Pmh - Waterbury Hospital for readmissions?

Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Pmh - Waterbury Hospital's base inpatient payments by an estimated 0.37% in fiscal year 2027 for more readmissions than expected.

What are the most common Medicare inpatient stays at Pmh - Waterbury Hospital?

In 2024, the most common were septicemia or severe sepsis without mv >96 hours with mcc (306 discharges), heart failure and shock with mcc (112 discharges), respiratory infections and inflammations with mcc (69 discharges).

What is Pmh - Waterbury Hospital's case mix index?

Pmh - Waterbury Hospital's Medicare case mix index is 1.79 for fiscal year 2027, higher than 61% of hospitals paid under the inpatient prospective payment system.

For hospital finance and compliance teams

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The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.

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CMS v3 example: standard_charge_information[0]
{
  "description": "MRI of brain (no contrast)",
  "code_information": [
    { "code": "611", "type": "RC" },
    { "code": "70551", "type": "CPT" }
  ],
  "standard_charges": [{
    "setting": "outpatient",
    "minimum": 250,
    "maximum": 400,
    "gross_charge": 1200,
    "discounted_cash": 1080,
    "payers_information": [
      {
        "payer_name": "Platform Health Insurance",
        "plan_name": "PPO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 400
      },
      {
        "payer_name": "Region Health Insurance",
        "plan_name": "HMO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 250
      }
    ]
  }]
}
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