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California 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 $62 · 10th–90th $41–$1120%10%10th90th$62Professionalmedian $60 · 10th–90th $36–$1290%10%10th90th$60$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$38.02 / $234.42 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $53.70 / $114.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $61.66 / $69.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $74.13 / $123.03
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $128.82 / $204.17
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $79.43 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $61.66
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $61.66 / $107.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $64.57 / $109.65
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $524.81 / $524.81
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $63.10 / $104.71
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $162.18
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $58.88 / $112.20