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Iowa 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 $65 · 10th–90th $40–$1230%10%10th90th$65Professionalmedian $55 · 10th–90th $36–$1020%10%10th90th$55$20.0$50.0$100.0$200.0$500.0

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
$46.77 / $46.77 / $74.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $52.48 / $83.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $69.18 / $120.23
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $89.13 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $64.57 / $123.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $97.72 / $407.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $104.71 / $154.88
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $109.65 / $173.78
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $134.90 / $169.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $60.26 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $69.18 / $120.23
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $66.07 / $104.71