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Nursing Facility Evaluation for Acute Change in Condition

Hawaii 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?

$186

Typical physician fee. In Hawaii, October 2026.

Insurers have agreed to pay about $186 for this service. Most negotiated rates run $158 to $229.

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

Professionalmedian $186 · 10th to 90th $158 to $229
$200professional $186

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

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$229.09
Typical High
$229.09
HMSA
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$208.93
Typical High
$257.04
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$194.98
United
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$229.09
Typical High
$316.23

Where Hawaii 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.

Hawaii· 39th of 51

$186

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.