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North Dakota 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 $65 · 10th–90th $39–$1120%20%10th90th$65Professionalmedian $60 · 10th–90th $37–$1290%10%10th90th$60$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 / $41.69 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $52.48 / $83.18
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $107.15 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $60.26 / $91.20
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $66.07 / $120.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $120.23 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $75.86 / $138.04