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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

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $51.29 / $83.18	Facility	$33.11	$51.29	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $48.98 / $75.86	Professional	$33.11	$48.98	$75.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $61.66 / $69.18	Facility	$50.12	$61.66	$69.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $61.66 / $100.00	Professional	$44.67	$61.66	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $239.88	Facility	$61.66	$61.66	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $79.43	Professional	$57.54	$57.54	$79.43
United Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $138.04 / $501.19	Facility	$38.90	$138.04	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $61.66 / $104.71	Professional	$38.02	$61.66	$104.71

Nationwide rates for HCPCS G0245

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