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Nursing Facility Evaluation for Acute Change in Condition

Utah 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 October 2026.

How much does Nursing Facility Evaluation for Acute Change in Condition cost?

$214

Typical physician fee. In Utah, October 2026.

Insurers have agreed to pay about $214 for this service. Most negotiated rates run $214 to $240.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $214 · 10th to 90th $214 to $214Professionalmedian $214 · 10th to 90th $195 to $275
$200facility $214professional $214

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$213.80
Median
$213.80
Typical High
$213.80
Aetna
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$213.80
Typical High
$213.80
Cigna
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Select Health
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$218.78
Median
$239.88
Typical High
$275.42
United
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$257.04
Typical High
$288.40

Where Utah sits

The same service costs 4.7 times more in Alaska than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Utah· 22nd of 51

$214

AK $708AL $151

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.