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Wisconsin 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 $23 · 10th–90th $16$550%10%20%10th90th$23Professionalmedian $31 · 10th–90th $15$760%10%10th90th$31$20.0$50.0$100.0$200.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $28.18 / $34.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $47.86 / $107.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $72.44 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $28.84 / $52.48
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $22.39 / $38.02
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $38.90
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $22.39 / $37.15
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $41.69 / $199.53
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $50.12 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $61.66 / $100.00
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $199.53
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $199.53 / $199.53
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $21.38 / $22.91
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $64.57 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $37.15 / $74.13