Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
PR E&M Diabetic Pt Foot Exam Loss of Protective Sensation Follow-Up
Low
$15
Average
$186
Median
$175
High
$400
Each hospital's average Excellus rate, under the methodology and billing class chosen below.
16 hospitals; the 90th percentile is 8.4× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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27 hospital rates
iThe hospitals that file a Excellus rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 2 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 3 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 2 | $378 | $378 | $81 | 21% | — | $297 – $459 |
| 4 | Highland Hospital Rochester, NY fee schedule · outpatient | 3 | $234 | $219 | $22 | 10% | — | $189 – $234 |
| 5 | MVHS, Inc. Utica, NY percent of total billed charges · bothfrom % of charges | 2 | $173 | $173 | — | — | — | $173 – $173 |
| 6 | Memorial Hosp of Wm F & Gertrude F Jones A/K/A Jones Memorial Hosp Wellsville, NY fee schedule · outpatient | 2 | $178 | $178 | — | — | — | $178 – $178 |
| 7 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $197 | $197 | — | — | — | $197 – $197 |
| 8 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · outpatient | 1 | $197 | $197 | — | — | — | $197 – $197 |
| 9 | Newark-Wayne Community Hospital Newark, NY facility · fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 10 | Nicholas H. Noyes Memorial Hospital Dansville, NY fee schedule · outpatient | 2 | $288 | $288 | — | — | — | $288 – $288 |
| 11 | Samaritan Hospital Troy, NY facility · fee schedule · both | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 12 | Samaritan Hospital Troy, NY facility · fee schedule · outpatient | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 13 | Samaritan Hospital Troy, NY facility · other · both | 1 | $183 | $183 | — | — | — | $183 – $183 |
| 14 | Samaritan Hospital Troy, NY facility · other · outpatient | 1 | $183 | $183 | — | — | — | $183 – $183 |
| 15 | Samaritan Hospital Troy, NY facility · percent of total billed charges · bothfrom % of charges | 2 | $458 | $458 | — | — | — | $458 – $458 |
| 16 | Samaritan Hospital Troy, NY professional · percent of total billed charges · inpatientfrom % of charges | 1 | $97 | $97 | — | — | — | $97 – $97 |
| 17 | Samaritan Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $98 | $98 | — | — | — | $98 – $98 |
| 18 | Samaritan Medical Center Watertown, NY facility · case rate · outpatient | 2 | $465 | $465 | $298 | 64% | — | $166 – $763 |
| 19 | Samaritan Medical Center Watertown, NY professional · fee schedule · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 20 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · fee schedule · both | 1 | $99 | $99 | — | — | — | $99 – $99 |
| 21 | St. James Hospital Hornell, NY fee schedule · outpatient | 2 | $400 | $400 | — | — | — | $400 – $400 |
| 22 | St. Joseph's Mercy Hospital, Centerville Centerville, IA professional · fee schedule · inpatient | 2 | $22 | $22 | $6 | 25% | — | $16 – $28 |
| 23 | St. Joseph's Mercy Hospital, Centerville Centerville, IA professional · fee schedule · outpatient | 2 | $42 | $42 | $12 | 28% | — | $30 – $54 |
| 24 | St. Joseph's Mercy Hospital, Centerville Centerville, IA professional · percent of total billed charges · inpatientfrom % of charges | 1 | $97 | $97 | — | — | — | $97 – $97 |
| 25 | St. Joseph's Mercy Hospital, Centerville Centerville, IA professional · percent of total billed charges · outpatientfrom % of charges | 1 | $99 | $99 | — | — | — | $99 – $99 |
← Payers reporting HCPCS G0246 · Snapshot 20261111T120946Z-9134e7f7