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South Carolina 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 $40–$1070%10%10th90th$65Professionalmedian $51 · 10th–90th $34–$720%10%10th90th$51$20.0$50.0$100.0$200.0$500.0$1.0K

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
$51.29 / $51.29 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $47.86 / $72.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $165.96 / $346.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $61.66 / $77.62
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
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $91.20 / $97.72
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $63.10 / $104.71
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $891.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $56.23 / $87.10