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Kentucky 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 $52 · 10th–90th $34–$620%20%10th90th$52Professionalmedian $52 · 10th–90th $37–$720%10%20%10th90th$52$50.0$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $39.81 / $63.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $50.12 / $72.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $53.70 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $60.26 / $302.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $57.54 / $87.10