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New Jersey rates for HCPCS G9874

Four total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service that: (1) is furnished by an MDPP supplier during months 1 through 6 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for core sessions

Facilitymedian $43 · 10th–90th $43–$430%50%$43Professionalmedian $56 · 10th–90th $38–$1150%10%10th90th$56$20.0$50.0$100.0$200.0$500.0

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
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $42.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $63.10 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $56.23 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $51.29 / $93.33