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Nursing Facility Evaluation for Acute Change in Condition

Washington, DC 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 October 2026.

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

$174

Typical physician fee. In Washington, DC, October 2026.

Insurers have agreed to pay about $174 for this service. Most negotiated rates run $174 to $398.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $174 · 10th to 90th $174 to $174Professionalmedian $178 · 10th to 90th $170 to $447
$200$500facility $174professional $178

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Aetna
Setting
Professional
Modifier
None
Typical Low
$169.82
Median
$173.78
Typical High
$173.78
Cigna
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
United
Setting
Professional
Modifier
None
Typical Low
$177.83
Median
$269.15
Typical High
$446.68

Where Washington, DC sits

The same service costs 4.7 times more in Alaska than in Alabama. 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.

Washington, DC· 44th of 51

$174

AK $708AL $151

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.