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Pennsylvania 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 $151 · 10th–90th $151$2190%50%90th$151Professionalmedian $155 · 10th–90th $145$2090%50%10th90th$155$200.0$1.0K$5.0K$20.0K

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
$151.36
Median
$151.36
Typical High
$151.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$154.88
Typical High
$204.17
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$190.55
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$154.88
Typical High
$204.17
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$218.78
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$218.78
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$251.19
Typical High
$380.19