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South 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

Facilitymedian $170 · 10th–90th $170–$2340%50%90th$170Professionalmedian $219 · 10th–90th $170–$3550%20%10th90th$219$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $169.82 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $251.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $234.42 / $371.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $257.04 / $416.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $309.03 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $338.84 / $501.19