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Diabetes Prevention Group Program Session

Illinois rates for HCPCS 0403T

A structured group session from a standardized program designed to prevent type 2 diabetes in people at high risk. A trained coach leads the group through eating patterns, physical activity and the practical habits that support weight loss and steadier blood sugar. Sessions are part of a course that runs over months rather than a single visit.

Rates data updated October 2026.

How much does Diabetes Prevention Group Program Session cost?

$19.95

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $19.95 for this service. The price depends on where it is billed: about $19.95 from a physician practice, and about $75.86 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$19.95$8.91 to $22.91
FacilityA hospital or hospital-owned outpatient department$75.86$38.02 to $120

How much rates vary

Facilitymedian $76 · 10th to 90th $20 to $155Professionalmedian $20 · 10th to 90th $7 to $28
$10$20$50$100facility $76professional $20

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$19.95
Median
$19.95
Typical High
$30.20
Aetna
Setting
Professional
Modifier
None
Typical Low
$19.95
Median
$19.95
Typical High
$30.20
Ambetter
Setting
Professional
Modifier
None
Typical Low
$20.42
Median
$20.42
Typical High
$20.42
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$38.02
Median
$81.28
Typical High
$162.18
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$7.08
Median
$17.38
Typical High
$27.54
Cigna
Setting
Professional
Modifier
None
Typical Low
$20.42
Median
$29.51
Typical High
$42.66
Hally Health
Setting
Professional
Modifier
None
Typical Low
$17.78
Median
$18.62
Typical High
$29.51
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Molina
Setting
Professional
Modifier
None
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
United
Setting
Professional
Modifier
None
Typical Low
$17.78
Median
$29.51
Typical High
$67.61

Where Illinois sits

The same service costs 5.8 times more in Nebraska than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 42nd of 51

$19.95

NE $89.13VT $15.49

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.