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Montana 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 $71 · 10th–90th $43–$1170%10%10th90th$71Professionalmedian $55 · 10th–90th $36–$1000%10%10th90th$55$20.0$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
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $52.48 / $83.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $102.33
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $100.00 / $117.49
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $100.00 / $117.49
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $66.07 / $117.49
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $97.72 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $77.62 / $114.82