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Nursing Facility Evaluation for Acute Change in Condition

Mississippi 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?

$214

Typical physician fee. In Mississippi, October 2026.

Insurers have agreed to pay about $214 for this service. Most negotiated rates run $174 to $214.

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 $214 · 10th to 90th $214 to $214Professionalmedian $195 · 10th to 90th $145 to $245
$200facility $214professional $195

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
$138.04
Median
$138.04
Typical High
$173.78
Aetna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$169.82
Typical High
$173.78
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$69.18
Median
$85.11
Typical High
$87.10
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$27.54
Median
$33.88
Typical High
$35.48
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$20.89
Median
$25.70
Typical High
$26.30
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$13.80
Median
$16.98
Typical High
$17.38
BCBS Mississippi
Setting
Facility
Modifier
None
Typical Low
$213.80
Median
$213.80
Typical High
$213.80
BCBS Mississippi
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$213.80
Typical High
$213.80
Cigna
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
United
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$199.53
Typical High
$275.42

Where Mississippi 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.

Mississippi· 24th of 51

$214

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.