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Montana rates for HCPCS G0245

Initial Physician Eval Of A Diabetic Pt Withdiabe Tic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (Lops) Which Must Include: 1-Diagnosis Of Lops 2-A Patient History 3-Physical Exam That Consists Of At Least The Following Elements: A) Visual Inspection Of The Forefoot Hindfoot & Toe Web Spaces B) Eval Of A Protective Sensation C) Eval Of Foot Structure & Biomechanics D) Eval Of Vascular Status & Skin Integrity & E) Eval & Recommendation Of Footwear & 4-Pt Education

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.46 / $58.39 / $103.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.04 / $62.04 / $102.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.14 / $62.04 / $102.01
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.82 / $62.08 / $120.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.24 / $93.72 / $154.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.63 / $108.00 / $129.03