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Nursing Facility Evaluation for Acute Change in Condition

Louisiana 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?

$200

Typical physician fee. In Louisiana, October 2026.

Insurers have agreed to pay about $200 for this service. Most negotiated rates run $145 to $240.

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

Facilitymedian $0 · 10th to 90th $0 to $0Professionalmedian $204 · 10th to 90th $145 to $275
$0.1$1$10$100facility $0professional $204

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
Aetna
Setting
Facility
Modifier
None
Typical Low
$194.98
Median
$194.98
Typical High
$213.80
Aetna
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$199.53
Typical High
$213.80
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$97.72
Median
$100.00
Typical High
$107.15
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$38.90
Median
$39.81
Typical High
$42.66
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$29.51
Median
$30.20
Typical High
$32.36
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$19.50
Median
$19.95
Typical High
$21.38
BCBS Louisiana
Setting
Facility
Modifier
None
Typical Low
$0.02
Median
$0.02
Typical High
$0.03
Cigna
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
United
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$251.19
Typical High
$323.59

Where Louisiana 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.

Louisiana· 31st of 51

$200

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.