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New York 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 $50 · 10th–90th $26–$830%20%10th90th$50Professionalmedian $55 · 10th–90th $34–$1150%10%20%10th90th$55$0.0$0.1$0.5$2.0$10.0$50.0$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
$25.70 / $25.70 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $60.26 / $114.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.03 / $22.39
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
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $51.29
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $50.12 / $104.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $52.48 / $117.49
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $48.98 / $51.29
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $48.98 / $83.18