Commercial healthcare reimbursement in Connecticut
How Connecticut compares with the nation, by payer, specialty and procedure.
Connecticut at a glance
What the data shows
Connecticut ranks 12th of 51 states for commercial reimbursement, with an index of 124 (100 = national median) across 228 procedure codes; the Northeast region averages 107.
Commercial rates in Connecticut run a median 201% of Medicare.
UnitedHealthcare has the highest index in the state (127) and Aetna the lowest (79), a 47-point gap, in the files analyzed.
CPT 93229 (Remote 30 day ecg tech supp) is the strongest relative to the national median (186% of it, a 86% premium); CPT 96910 (Photchmtx tar&uvb/ptrltm&uvb) is furthest below (84% of the national median, 16% lower).
By specialty, Connecticut is strongest for gastroenterology (ranks 6th of 50 states for that specialty) and weakest for dermatology (17th of 50).
Against Medicare, gastroenterology has the highest ratio in Connecticut (247% of Medicare) and dermatology the lowest (108%).
Payer ranking in Connecticut
| Payer | Index | Rank | Level | Codes | Providers | TINs |
|---|---|---|---|---|---|---|
| UnitedHealthcare | 127 | 1 | 228 | 804 | 463 | |
| Cigna | 107 | 2 | 227 | 855 | 544 | |
| Blue Cross Blue Shield | 100 | 3 | 228 | 887 | 602 | |
| Aetna | 79 | 4 | 228 | 754 | 522 |
Reimbursement index by specialty in Connecticut
| Specialty | Index | Rank among states | % of Medicare | Level | Codes | Providers |
|---|---|---|---|---|---|---|
| Gastroenterology | 136 | 6 of 50 | 247% | 36 | 122 | |
| Cardiology | 134 | 8 of 51 | 196% | 38 | 119 | |
| Diagnostic radiology | 117 | 10 of 51 | 179% | 49 | 125 | |
| Orthopedic surgery | 126 | 10 of 51 | 201% | 39 | 114 | |
| Ophthalmology | 126 | 11 of 50 | 154% | 42 | 111 | |
| Urology | 115 | 13 of 50 | 211% | 37 | 116 | |
| Internal medicine | 116 | 15 of 51 | 128% | 25 | 119 | |
| Dermatology | 109 | 17 of 50 | 108% | 44 | 109 |
Specialty by payer in Connecticut
| Specialty | UHC | Aetna | Cigna | BCBS |
|---|---|---|---|---|
| Internal medicine | 142 | 77 | 113 | 124 |
| Dermatology | 162 | 90 | 121 | 102 |
| Ophthalmology | 160 | 104 | 130 | 130 |
| Cardiology | 161 | 99 | 149 | 144 |
| Orthopedic surgery | 160 | 81 | 124 | 119 |
| Diagnostic radiology | 140 | 96 | 119 | 124 |
| Urology | 142 | 94 | 119 | 117 |
| Gastroenterology | 186 | 82 | 136 | 139 |
Connecticut compared with Northeast region states
| State | Index | Rank | % of Medicare | Providers | Level |
|---|---|---|---|---|---|
| Connecticut | 124 | 12 | 201% | 935 | |
| Massachusetts | 123 | 13 | 190% | 921 | |
| New Hampshire | 121 | 14 | 174% | 734 | |
| Vermont | 107 | 18 | 157% | 365 | |
| New Jersey | 100 | 22 | 154% | 887 | |
| Maine | 100 | 23 | 148% | 647 |
Procedures that pay most and least in Connecticut vs the nation
Highest vs national
| Code | Connecticut | National | Gap | Prov. |
|---|---|---|---|---|
| 93229 Remote 30 day ecg tech supp | $2,029 | $1,088 | +86% | 119 |
| 46221 Ligation of hemorrhoid(s) | $598 | $346 | +73% | 122 |
| 45390 Colonoscopy w/resection | $851 | $532 | +60% | 119 |
| 96372 Ther/proph/diag inj sc/im | $38 | $24 | +58% | 119 |
| 72148 Mri lumbar spine w/o dye | $600 | $382 | +57% | 233 |
| 96413 Chemo iv infusion 1 hr | $318 | $204 | +56% | 121 |
| 93306 Tte w/doppler complete | $488 | $318 | +53% | 236 |
| 75574 Ct angio hrt w/3d image | $759 | $495 | +53% | 116 |
| 92136 Ophthalmic biometry | $105 | $69 | +53% | 111 |
| 43274 Ercp duct stent placement | $1,126 | $739 | +52% | 122 |
| 43276 Ercp stent exchange w/dilate | $1,172 | $771 | +52% | 121 |
| 66991 Xcapsl ctrc rmvl insj 1+ | $1,275 | $840 | +52% | 109 |
| 73221 Mri joint upr extrem w/o dye | $600 | $399 | +51% | 233 |
| 73721 Mri jnt of lwr extre w/o dye | $600 | $399 | +50% | 233 |
| 93312 Echo transesophageal | $582 | $387 | +50% | 118 |
Lowest vs national
| Code | Connecticut | National | Gap | Prov. |
|---|---|---|---|---|
| 96910 Photchmtx tar&uvb/ptrltm&uvb | $105 | $125 | -16% | 109 |
| 97110 Therapeutic exercises | $30 | $31 | -3% | 114 |
| 93297 Rem interrog dev eval icpms | $51 | $52 | -2% | 118 |
| 11301 Shave skin lesion 0.6-1.0 cm | $84 | $85 | -1% | 109 |
| 76642 Ultrasound breast limited | $120 | $120 | +0% | 124 |
| 76641 Ultrasound breast complete | $146 | $145 | +0% | 124 |
| 76536 Us exam of head and neck | $157 | $154 | +2% | 124 |
| 76705 Echo exam of abdomen | $128 | $126 | +2% | 119 |
| 99212 Office o/p est sf 10 min | $50 | $49 | +2% | 933 |
| 99497 Advncd care plan 30 min | $111 | $108 | +3% | 118 |
| 76700 Us exam abdom complete | $173 | $168 | +3% | 119 |
| 93298 Rem interrog dev eval scrms | $54 | $52 | +3% | 119 |
| 52224 Cystoscopy and treatment | $474 | $459 | +3% | 116 |
| 64566 Neuroeltrd stim post tibial | $72 | $69 | +3% | 116 |
| 92012 Intrm oph exam est patient | $78 | $76 | +4% | 111 |
Frequently asked questions
How do commercial reimbursement rates in Connecticut compare with the rest of the country?
Connecticut ranks 12th of 51 states with an index of 124, across 228 procedure codes. Median commercial rates run 201% of the Medicare rate.
Which payer has the highest rates in Connecticut?
In the files we analyzed, UnitedHealthcare has the highest index (127) and Aetna the lowest (79). Each payer's figures describe the specific plans and networks in the files used, not its whole book of business.
Which specialty has the strongest rates in Connecticut?
Gastroenterology ranks 6th of 50 states.
How many providers does this Connecticut page cover?
935 sampled providers across 4 payers. The data comes from a random sample of providers, so counts describe the sample, not every provider in the state.
Which procedures differ most between Connecticut and the national median?
CPT 93229 (Remote 30 day ecg tech supp) is highest relative to the nation at 186% of the national median; CPT 96910 (Photchmtx tar&uvb/ptrltm&uvb) is lowest at 84%.
Methodology
- Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
- Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
- Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
- Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
- Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
- Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.
Benchmark your Connecticut contracts
Compare your negotiated rates with these state medians by payer and specialty.