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Nursing Facility Evaluation for Acute Change in Condition

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

Rates data updated July 2026.

Facilitymedian $234 · 10th–90th $195$3720%20%40%10th90th$234Professionalmedian $229 · 10th–90th $138$3550%10%20%10th90th$229$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
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$251.19
Medica
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$234.42
Typical High
$371.54
Medica
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$257.04
Typical High
$416.87
Midlands
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$323.59
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$309.03
Typical High
$354.81
United
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$338.84
Typical High
$501.19
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42