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Wisconsin 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 $347 · 10th–90th $158–$8910%20%10th90th$347Professionalmedian $191 · 10th–90th $158–$4900%20%10th90th$191$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $165.96 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $562.34 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $251.19 / $346.74
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $204.17 / $371.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $204.17 / $371.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $354.81 / $549.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $64.57
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $371.54 / $512.86
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $1,202.26
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $1,202.26
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $331.13
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $346.74 / $575.44