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Nursing Facility Evaluation for Acute Change in Condition

Idaho 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 $148 · 10th–90th $148$2510%50%90th$148Professionalmedian $219 · 10th–90th $148$2750%20%10th90th$219$100.0$200.0

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

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Aetna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$218.78
Typical High
$245.47
BCBS
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$208.93
Typical High
$251.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$302.00
Typical High
$363.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$245.47
Typical High
$354.81
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$275.42
Typical High
$316.23
Molina
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$77.62
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$275.42
Typical High
$302.00
Select Health
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$147.91
Typical High
$389.05
Select Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
United
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$251.19
Typical High
$363.08