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Nursing Facility Evaluation for Acute Change in Condition

North Dakota 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?

$324

Typical physician fee. In North Dakota, October 2026.

Insurers have agreed to pay about $324 for this service. Most negotiated rates run $240 to $380.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $200 · 10th to 90th $200 to $263Professionalmedian $355 · 10th to 90th $204 to $407
$200$500facility $200professional $355

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Aetna
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$199.53
Typical High
$199.53
BCBS North Dakota
Setting
Professional
Modifier
None
Typical Low
$275.42
Median
$363.08
Typical High
$416.87
BCBS North Dakota
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$54.95
Median
$72.44
Typical High
$83.18
Cigna
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$204.17
Typical High
$251.19
Medica
Setting
Facility
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$602.56
Medica
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$380.19
Typical High
$436.52
United
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$363.08
Typical High
$398.11

Where North Dakota 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.

North Dakota· 5th of 51

$324

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.