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Utah 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 $58 · 10th–90th $58–$830%20%40%90th$58Professionalmedian $52 · 10th–90th $33–$830%10%10th90th$52$50.0$100.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $50.12 / $77.62
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 / $47.86
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $66.07 / $97.72
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $66.07 / $77.62
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $74.13 / $114.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $61.66 / $97.72