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New Mexico 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 $38–$1070%10%10th90th$65Professionalmedian $49 · 10th–90th $31–$790%10%10th90th$49$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
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $48.98 / $75.86
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $45.71 / $74.13
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
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $64.57 / $107.15
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $83.18 / $575.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $72.44 / $114.82