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Maryland 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 $43 · 10th–90th $32–$650%10%20%10th90th$43Professionalmedian $50 · 10th–90th $33–$740%10%10th90th$50$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $46.77 / $72.44
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
$39.81 / $69.18 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $42.66 / $64.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $61.66 / $102.33
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $89.13 / $100.00