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Pennsylvania rates for HCPCS 0403T

Preventive behavior change, intensive program of prevention of diabetes using a standardized diabetes prevention program curriculum, provided to individuals in a group setting, minimum 60 minutes, per day

Facilitymedian $55 · 10th–90th $55–$550%50%100%$55Professionalmedian $28 · 10th–90th $15–$350%20%10th90th$28$20.0$50.0$100.0

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
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $28.18 / $33.88
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $26.92 / $26.92
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $25.70 / $41.69
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $28.84 / $42.66
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $28.18 / $34.67
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $26.92 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $30.90 / $52.48