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Nursing Facility Evaluation for Acute Change in Condition

Washington 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 $347 · 10th–90th $219$3800%20%40%10th90th$347Professionalmedian $219 · 10th–90th $158$4370%20%40%10th90th$219$50.0$100.0$200.0$500.0

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
$158.49
Median
$218.78
Typical High
$218.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$363.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$363.08
Typical High
$380.19
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$257.04
Typical High
$436.52
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$363.08
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$295.12
Typical High
$512.86
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$213.80
Typical High
$316.23