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Texas 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 $162 · 10th–90th $158–$1,2020%50%10th90th$162Professionalmedian $158 · 10th–90th $151–$2000%20%40%10th90th$158$50.0$100.0$200.0$500.0$1.0K

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
$158.49 / $158.49 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $158.49 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,513.56 / $1,513.56
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $162.18 / $234.42
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $158.49 / $173.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $162.18 / $229.09
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $218.78 / $309.03