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Nursing Facility Evaluation for Acute Change in Condition

Arizona rates for HCPCS G9685

Physician service or other qualified health care professional for the evaluation and management of a beneficiary's acute change in condition in a nursing facility. This service is for a demonstration project

Rates data updated July 2026.

How much does Nursing Facility Evaluation for Acute Change in Condition cost?

$191

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $191 for this service. The price depends on where it is billed: about $151 from a physician practice, and about $372 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$151$141 to $219
FacilityA hospital or hospital-owned outpatient department$372$178 to $525

How much rates vary

Facilitymedian $372 · 10th to 90th $89 to $741Professionalmedian $151 · 10th to 90th $141 to $324
$100$200$500$1Kfacility $372professional $151

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$151.36
BCBS
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$380.19
Typical High
$741.31
BCBS
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$954.99
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Medica
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$204.17
Typical High
$933.25
Medica
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$229.09
Typical High
$457.09
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$457.09
United
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$218.78
Typical High
$338.84

Where Arizona sits

The same service costs 3.5 times more in Alaska than in Indiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Arizona· 23rd of 51

$191

AK $468IN $135

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.