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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 July 2026.

Facilitymedian $214 · 10th–90th $214$2140%50%$214Professionalmedian $214 · 10th–90th $214$2630%50%90th$214$200.0

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
$213.80
Median
$213.80
Typical High
$213.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$213.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Select Health
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$263.03
Typical High
$263.03
United
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$257.04
Typical High
$288.40