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Massachusetts 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

Facilitymedian $490 · 10th–90th $158–$6920%10%10th90th$490Professionalmedian $191 · 10th–90th $155–$3020%20%10th90th$191$100.0$500.0$2.0K$10.0K$50.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $190.55 / $239.88
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $269.15 / $524.81
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $524.81 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $245.47
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $173.78 / $1,995.26
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $218.78 / $363.08
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $190.55 / $338.84
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $269.15 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $269.15 / $549.54