{"reporting_entity_name": "Connecticare_CCI_COM","reporting_entity_type": "Third Party","last_updated_on": "2026-07-22","version": "1.0.0","provider_references": [                                                                                                                                                                       
{"provider_group_id":1624869935,"provider_groups":[{"npi":[1407907215],"tin":{"type":"ein","value":"160919175"}}]}
],"in_network": [
{"negotiation_arrangement":"ffs","name":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57454","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of missed abortion, completed surgically; second trimester","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59821","description":"Treatment of missed abortion, completed surgically; second trimester","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Induced abortion, by dilation and evacuation","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59841","description":"Induced abortion, by dilation and evacuation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Removal with reinsertion, non-biodegradable drug delivery implant","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11983","description":"Removal with reinsertion, non-biodegradable drug delivery implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of missed abortion, completed surgically; first trimester","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59820","description":"Treatment of missed abortion, completed surgically; first trimester","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56501","description":"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of incomplete abortion, any trimester, completed surgically","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59812","description":"Treatment of incomplete abortion, any trimester, completed surgically","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Induced abortion, by dilation and curettage","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","description":"Induced abortion, by dilation and curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"INSERTION DRUG DLVR IMPLANT","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11981","description":"INSERTION DRUG DLVR IMPLANT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55250","description":"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Removal, non-biodegradable drug delivery implant","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11982","description":"Removal, non-biodegradable drug delivery implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54050","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of intrauterine device (IUD)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58300","description":"Insertion of intrauterine device (IUD)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Induced abortion, by dilation and curettage","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","description":"Induced abortion, by dilation and curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Induced abortion, by dilation and evacuation","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59841","description":"Induced abortion, by dilation and evacuation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Removal, non-biodegradable drug delivery implant","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11982","description":"Removal, non-biodegradable drug delivery implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56501","description":"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of missed abortion, completed surgically; second trimester","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59821","description":"Treatment of missed abortion, completed surgically; second trimester","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of missed abortion, completed surgically; first trimester","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59820","description":"Treatment of missed abortion, completed surgically; first trimester","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54050","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of intrauterine device (IUD)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58300","description":"Insertion of intrauterine device (IUD)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57454","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55250","description":"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Removal with reinsertion, non-biodegradable drug delivery implant","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11983","description":"Removal with reinsertion, non-biodegradable drug delivery implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of incomplete abortion, any trimester, completed surgically","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59812","description":"Treatment of incomplete abortion, any trimester, completed surgically","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]},
{"negotiation_arrangement":"ffs","name":"INSERTION DRUG DLVR IMPLANT","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11981","description":"INSERTION DRUG DLVR IMPLANT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.0,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":[1624869935]}]}]}
