{"reporting_entity_name":"Molina-Healthcare-of-Connecticut","reporting_entity_type":"health insurance issuer","last_updated_on":"2026-08-15","version":"2.0.0","provider_references":[{"provider_group_id":219695,"network_name":["CT Network"],"provider_groups":[{"npi":[1720227945],"tin":{"type":"ein","value":"061521999","business_name":"WESTERN CONNECTICUT ORTHOPEDIC SURGICAL CENTER LLC"}}]}],"in_network":[{"negotiation_arrangement":"ffs","name":"Clinic - General","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0510","description":"Clinic","negotiated_rates":[{"provider_references":[219695],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":1.55,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":1569.48,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":2072.23,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":2095.87,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":3049.8,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":3079.88,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":3174.41,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":3227.06,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":3257.13,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":3286.13,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":3297.96,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":3375.3,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":3405.37,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":3464.46,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4145.54,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4204.62,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4233.62,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4322.79,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4358.24,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4381.87,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4560.2,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4631.1,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4707.37,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4737.45,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4749.26,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4855.62,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4885.7,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"fee schedule","negotiated_rate":4944.78,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":5000.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"per diem","negotiated_rate":1042.02,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"per diem","negotiated_rate":1391.16,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"per diem","negotiated_rate":1569.48,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"per diem","negotiated_rate":2072.23,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"per diem","negotiated_rate":2842.46,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"per diem","negotiated_rate":3908.13,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"per diem","negotiated_rate":4204.62,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"per diem","negotiated_rate":4476.4,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"per diem","negotiated_rate":4501.12,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"per diem","negotiated_rate":4589.2,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]},{"setting":"outpatient","negotiated_type":"per diem","negotiated_rate":994.76,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Medical/Surgical Supplies and Devices - Intraocular Lens","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0276","description":"Med/Surg Supplies &Devices (also see 062x, extension of 027x","negotiated_rates":[{"provider_references":[219695],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":5000.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Medical/Surgical Supplies and Devices - Other Implants","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0278","description":"Med/Surg Supplies &Devices (also see 062x, extension of 027x","negotiated_rates":[{"provider_references":[219695],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":5000.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Medical/Surgical Supplies and Devices - Pacemaker","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0275","description":"Med/Surg Supplies &Devices (also see 062x, extension of 027x","negotiated_rates":[{"provider_references":[219695],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":5000.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Medical/Surgical Supplies and Devices - Prosthetic/Orthotic","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0274","description":"Med/Surg Supplies &Devices (also see 062x, extension of 027x","negotiated_rates":[{"provider_references":[219695],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":5000.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]}]}