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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

Facilitymedian $200 · 10th–90th $174–$10,0000%20%10th90th$200Professionalmedian $191 · 10th–90th $151–$2570%20%10th90th$191$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $190.55 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $204.17 / $229.09
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $162.18 / $363.08
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $524.81 / $10,000.00
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $524.81 / $10,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $288.40 / $426.58