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Nursing Facility Evaluation for Acute Change in Condition

Virginia 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 $200 · 10th–90th $174$10,0000%20%10th90th$200Professionalmedian $195 · 10th–90th $162$3020%20%10th90th$195$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$199.53
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$190.55
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$204.17
Typical High
$229.09
Medcost
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$162.18
Typical High
$363.08
Sentara
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$524.81
Typical High
$10,000.00
Sentara
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$524.81
Typical High
$10,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$288.40
Typical High
$426.58