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Kansas 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 $60 · 10th–90th $38–$1000%20%10th90th$60Professionalmedian $60 · 10th–90th $36–$950%10%20%10th90th$60$20.0$100.0$500.0$2.0K$10.0K$50.0K$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
$38.02 / $45.71 / $60.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $47.86 / $72.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $61.66 / $61.66
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $60.26 / $117.49
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $87.10 / $407.38
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
$43.65 / $64.57 / $89.13