go back

Nursing Facility Evaluation for Acute Change in Condition

North Carolina 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 $191 · 10th–90th $191$2950%50%90th$191Professionalmedian $191 · 10th–90th $158$2950%50%10th90th$191$100.0$200.0$500.0$1.0K

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
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$295.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$199.53
BCBS
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$190.55
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Medcost
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$190.55
Typical High
$263.03
United
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$257.04
Typical High
$398.11
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,202.26