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Nursing Facility Evaluation for Acute Change in Condition

Iowa 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.

Facilitymedian $347 · 10th–90th $155$9330%20%10th90th$347Professionalmedian $166 · 10th–90th $151$2290%20%40%10th90th$166$1.0$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$154.88
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$251.19
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$169.82
Typical High
$309.03
Medica
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$346.74
Typical High
$933.25
Medica
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$281.84
Typical High
$457.09
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1.23
Median
$436.52
Typical High
$436.52
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$245.47
Typical High
$457.09
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$213.80