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Nebraska 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 $38–$1200%10%20%10th90th$71Professionalmedian $54 · 10th–90th $33–$850%20%10th90th$54$0.1$0.5$2.0$10.0$50.0$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
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $60.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $48.98 / $72.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $72.44 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $72.44 / $128.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $70.79 / $120.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $114.82 / $407.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $93.33 / $151.36
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $89.13 / $151.36
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $144.54 / $169.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.07 / $0.07 / $0.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $77.62 / $134.90