go back

Montana rates for HCPCS G0247

Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (LOPS) to include the local care of superficial wounds (i.e., superficial to muscle and fascia) and at least the following, if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.43 / $53.63 / $130.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.65 / $33.65 / $33.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.65 / $74.09 / $133.03
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.17 / $55.65 / $107.53
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.65 / $87.27 / $209.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.80 / $123.75 / $168.71