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Ohio 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 $60 · 10th–90th $38–$810%50%10th90th$60Professionalmedian $56 · 10th–90th $36–$830%20%10th90th$56$0.1$0.2$1.0$5.0$20.0$100.0$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
$38.02 / $60.26 / $81.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $50.12 / $74.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $61.66 / $97.72
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
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $63.10 / $104.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $363.08 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $58.88 / $95.50