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New York rates for HCPCS G0246

Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (LOPS) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot, and toe web spaces, (b) evaluation of 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 (3) patient education

Facilitymedian $23 · 10th–90th $12–$450%10%20%10th90th$23Professionalmedian $36 · 10th–90th $18–$790%10%10th90th$36$1.0$5.0$20.0$100.0

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
$12.02 / $22.91 / $44.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $25.12 / $42.66
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$37.15 / $37.15 / $37.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $36.31 / $60.26
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $53.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $56.23
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $40.74 / $165.96
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $56.23 / $83.18
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $42.66
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $42.66 / $83.18
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $93.33
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $53.70 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $35.48 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $57.54 / $173.78
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $21.38 / $36.31
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $38.90 / $67.61