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Colorado 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 $46 · 10th–90th $0–$680%20%10th90th$46Professionalmedian $52 · 10th–90th $35–$830%10%20%10th90th$52$0.1$0.5$2.0$10.0$50.0$200.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $35.48 / $67.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $46.77 / $72.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $66.07 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $93.33 / $154.88
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $63.10 / $67.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.07 / $0.07 / $0.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $70.79 / $112.20