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New York 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

Facilitymedian $186 · 10th–90th $151$2880%10%20%10th90th$186Professionalmedian $178 · 10th–90th $145$2570%20%10th90th$178$100.0$500.0$2.0K$10.0K$50.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $165.96 / $218.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $169.82 / $239.88
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $870.96
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $213.80 / $588.84
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $275.42 / $575.44
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $173.78 / $173.78
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $177.83 / $338.84
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $645.65 / $870.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $239.88 / $489.78
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $173.78 / $208.93
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $199.53 / $338.84