What does Centene pay for CPT 43245 in Orlando-Kissimmee-Sanford, FL?

The local peer median for CPT 43245 under Centene in Orlando-Kissimmee-Sanford, FL is $218.92, based on 2725 indexed providers. Modeled from published rates, not guaranteed.

What is the top of the local market (P90) for CPT 43245 under Centene in Orlando-Kissimmee-Sanford, FL?

The P90, the top of the local market and Reddenda's target rate, is $218.92.

How does Centene's rate for CPT 43245 compare to Medicare?

The Centene local median of $218.92 is 33% of Medicare's national non-facility rate of $654.99 for CPT 43245.

Reddenda · Rate Intelligence · Orlando-Kissimmee-Sanford, FL

43245 under Centene in Orlando-Kissimmee-Sanford, FL

Name: Centene rates for CPT 43245 in Orlando-Kissimmee-Sanford, FL
Creator: Reddenda

EGD w/ dilation gastric outlet · Local peer median $218.92 · Medium confidence

$218.92 local peer median. In the Orlando-Kissimmee-Sanford, FL market, Centene pays a local peer median of $218.92 for CPT 43245 (EGD w/ dilation gastric outlet), based on 2725 providers in Reddenda's index of Centene's own published in-network rates. The top of the local market, the P90 target, is $218.92, which is the same as the median here: this payer's filed rates for this code cluster on one number, so the opportunity in this cell is reaching the median rather than exceeding it. A provider billed below the local median is being paid less than peers holding the identical Centene contract in Orlando-Kissimmee-Sanford, FL for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 2725 providers · 2725 rate records

P10

$73.78

P25

$147.57

Median

$218.92

P75

$218.92

P90 (target)

$218.92

P10$73.78

P25$147.57

Median (P50)$218.92

P75$218.92

P90 target$218.92

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $73.78 – $1,043.35

The local peer median for CPT 43245 under Centene in Orlando-Kissimmee-Sanford, FL is $218.92, drawn from 2725 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
The bottom of the local market (P10) is $73.78 and the top (P90) is $218.92; the median-to-P90 spread is $0.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
The lowest published rate in this market is $73.78; the highest is $1,043.35.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
This benchmark is drawn from 2725 individual rate records that Centene itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
Medicare's national non-facility rate for CPT 43245 is $654.99, making the Centene local median 33% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
61% 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 Centene 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)

2725 providers bill this code to this payer in this metro.

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This is the local market for CPT 43245 (EGD w/ dilation gastric outlet) under Centene in Orlando-Kissimmee-Sanford, FL. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

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Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Centene'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 Centene to publish this rate. Page generated 2026-08-23 22:56 UTC; the live index is queried in real time on every request.