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Maine 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

Professionalmedian $195 · 10th–90th $162–$2400%20%10th90th$195$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $177.83 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $223.87 / $263.03
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $177.83 / $239.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $281.84 / $346.74