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Nursing Facility Evaluation for Acute Change in Condition

Kansas 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?

$245

Typical physician fee. In Kansas, October 2026.

Insurers have agreed to pay about $245 for this service. Most negotiated rates run $204 to $295.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $204 · 10th to 90th $158 to $347Professionalmedian $245 · 10th to 90th $166 to $295
$200$500$1Kfacility $204professional $245

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
$186.21
Median
$186.21
Typical High
$186.21
Aetna
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$186.21
Typical High
$186.21
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$79.43
Median
$91.20
Typical High
$91.20
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$31.62
Median
$37.15
Typical High
$37.15
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$23.44
Median
$27.54
Typical High
$27.54
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$15.85
Median
$18.62
Typical High
$18.62
BCBS Kansas
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$295.12
Typical High
$295.12
Cigna
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Medica
Setting
Facility
Modifier
None
Typical Low
$158.49
Median
$234.42
Typical High
$933.25
Medica
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$234.42
Typical High
$309.03
United
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$234.42
Typical High
$331.13

Where Kansas 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.

Kansas· 13th of 51

$245

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.