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Nursing Facility Evaluation for Acute Change in Condition

Michigan 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.

Facilitymedian $195 · 10th–90th $195$4900%50%90th$195Professionalmedian $209 · 10th–90th $158$2400%20%10th90th$209$200.0$500.0

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
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$194.98
Typical High
$218.78
BCBS
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$239.88
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$524.81
Typical High
$588.84
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$199.53
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$239.88
Typical High
$302.00