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Nationwide rates for HCPCS G0245

Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (LOPS) which must include: (1) the diagnosis of LOPS, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot, and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (4) patient education

Facilitymedian $63 · 10th–90th $38–$1260%20%10th90th$63Professionalmedian $56 · 10th–90th $34–$1050%20%40%10th90th$56$0.1$1.0$20.0$500.0$10.0K$200.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $51.29 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $48.98 / $74.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $61.66 / $69.18
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $61.66 / $104.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $81.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $61.66 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $64.57 / $123.03

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