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Missouri 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 $63 · 10th–90th $38–$1200%10%10th90th$63Professionalmedian $52 · 10th–90th $36–$810%10%10th90th$52$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
$45.71 / $45.71 / $63.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $48.98 / $75.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $56.23 / $75.86
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $67.61 / $95.50
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
$60.26 / $60.26 / $60.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $63.10 / $120.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $79.43 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $851.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $57.54 / $91.20