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Texas 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 $36–$1230%5%10%10th90th$65Professionalmedian $47 · 10th–90th $33–$710%10%10th90th$47$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
$22.91 / $37.15 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $46.77 / $72.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $60.26
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $309.03 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $45.71 / $53.70
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $66.07
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
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $524.81 / $524.81
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $63.10 / $109.65
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $52.48 / $91.20
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $169.82
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $63.10 / $109.65
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $123.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $57.54 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $58.88 / $93.33
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $66.07 / $79.43