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Diabetes Prevention Group Program Session

Pennsylvania 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 July 2026.

How much does Diabetes Prevention Group Program Session cost?

$28.84

Typical physician fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $28.84 for this service. Most negotiated rates run $15.49 to $32.36.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $59 · 10th to 90th $59 to $59Professionalmedian $29 · 10th to 90th $15 to $36
$20$50$100facility $59professional $29

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$28.84
Typical High
$36.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$25.70
Typical High
$41.69
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$28.84
Typical High
$42.66
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$23.99
Typical High
$33.11
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$26.92
Typical High
$29.51
United
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$32.36
Typical High
$53.70

Where Pennsylvania sits

The same service costs 2.1 times more in Montana than in Minnesota. 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.

Pennsylvania· 39th of 51

$28.84

MT $32.36MN $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.