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Nursing Facility Evaluation for Acute Change in Condition

Indiana 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?

$135

Typical physician fee. In Indiana, July 2026.

Insurers have agreed to pay about $135 for this service. Most negotiated rates run $135 to $162.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $135 · 10th to 90th $135 to $174Professionalmedian $141 · 10th to 90th $135 to $200
$200$500facility $135professional $141

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
Facility
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$169.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$144.54
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$223.87
Typical High
$302.00

Where Indiana 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.

Indiana· 51st of 51

$135

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.