Reddenda · Rate Intelligence · Los Angeles-Long Beach-Anaheim, CA

43245 under Anthem Blue Cross (CA) in Los Angeles-Long Beach-Anaheim, CA

EGD w/ dilation gastric outlet · Local peer median $242.73 · High confidence

• The local peer median for CPT 43245 under Anthem Blue Cross (CA) in Los Angeles-Long Beach-Anaheim, CA is $242.73, drawn from 1237 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross (CA) to publish this rate
• The bottom of the local market (P10) is $222.33 and the top (P90) is $2,092.08; the median-to-P90 spread is $1,849.35.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross (CA) to publish this rate
• The lowest published rate in this market is $90; the highest is $3,379.22.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross (CA) to publish this rate
• This benchmark is drawn from 1268 individual rate records that Anthem Blue Cross (CA) itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross (CA) to publish this rate
• Medicare's national non-facility rate for CPT 43245 is $654.99, making the Anthem Blue Cross (CA) local median 37% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross (CA) to publish this rate
• 26.7% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross (CA) to publish this rate
• A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

Modeled from Anthem Blue Cross (CA)'s own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross (CA) to publish this rate. Page generated 2026-08-23 23:41 UTC; the live index is queried in real time on every request.