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Wisconsin 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 $36–$1230%10%10th90th$60Professionalmedian $58 · 10th–90th $36–$1260%10%10th90th$58$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
$36.31 / $36.31 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $48.98 / $72.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $77.62 / $169.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $204.17 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $72.44 / $165.96
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $58.88 / $109.65
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $109.65 / $169.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $58.88 / $114.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $114.82 / $407.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $89.13 / $144.54
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $104.71 / $181.97
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $257.04
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $138.04 / $407.38
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $77.62
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $89.13 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $74.13 / $134.90