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Nursing Facility Evaluation for Acute Change in Condition

New Hampshire 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?

$269

Typical physician fee. In New Hampshire, October 2026.

Insurers have agreed to pay about $269 for this service. Most negotiated rates run $219 to $331.

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

Professionalmedian $269 · 10th to 90th $145 to $501
$200$500professional $269

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
Professional
Modifier
None
Typical Low
$199.53
Median
$218.78
Typical High
$218.78
Cigna
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$295.12
Typical High
$549.54
United
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$316.23
Typical High
$524.81
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Well Sense
Setting
Facility
Modifier
HN · Bachelor's level + HO · Master's level + SA · Nurse practitioner
Typical Low
$154.88
Median
$154.88
Typical High
$154.88

Where New Hampshire 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.

New Hampshire· 7th of 51

$269

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.