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Michigan 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 $62 · 10th–90th $39–$680%20%10th90th$62Professionalmedian $52 · 10th–90th $36–$740%10%10th90th$52$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
$38.90 / $39.81 / $61.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $48.98 / $72.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $58.88 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $60.26 / $89.13
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $63.10 / $107.15
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $60.26 / $87.10
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $75.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $67.61 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $60.26 / $93.33