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Oregon 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 $83 · 10th–90th $42–$1260%10%20%10th90th$83Professionalmedian $63 · 10th–90th $37–$1380%10%20%10th90th$63$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
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $52.48 / $83.18
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $97.72 / $158.49
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $67.61 / $120.23
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $97.72 / $151.36
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $125.89 / $128.82
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $67.61 / $123.03
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $97.72 / $162.18
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $457.09 / $501.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $107.15 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $91.20 / $147.91