Reddenda · Rate Intelligence · San Jose-Sunnyvale-Santa Clara, CA

45386 under UnitedHealthcare in San Jose-Sunnyvale-Santa Clara, CA

Colonoscopy w/ balloon dilation · Local peer median $1,022.96 · High confidence

• The local peer median for CPT 45386 under UnitedHealthcare in San Jose-Sunnyvale-Santa Clara, CA is $1,022.96, drawn from 258 distinct providers.Source: UnitedHealthcare’s published machine-readable files
• The bottom of the local market (P10) is $624.49 and the top (P90) is $3,439.11; the median-to-P90 spread is $2,416.15.Source: UnitedHealthcare’s published machine-readable files
• The lowest published rate in this market is $177.19; the highest is $3,515.53.Source: UnitedHealthcare’s published machine-readable files
• This benchmark is drawn from 258 individual rate records that UnitedHealthcare itself published for this code in this metro.Source: UnitedHealthcare’s published machine-readable files
• Medicare's national non-facility rate for CPT 45386 is $670.36, making the UnitedHealthcare local median 153% of Medicare.Source: Medicare Physician Fee Schedule; UnitedHealthcare’s published machine-readable files
• 36% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: UnitedHealthcare’s published machine-readable files
• 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 UnitedHealthcare'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: UnitedHealthcare’s published machine-readable files. Page generated 2026-08-24 10:37 UTC; the live index is queried in real time on every request.