go back

Wisconsin 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 $107 · 10th–90th $44–$2690%10%20%10th90th$107Professionalmedian $83 · 10th–90th $40–$1260%10%10th90th$83$1.0$5.0$20.0$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $74.13 / $117.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $74.13 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $354.81 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $87.10 / $158.49
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $104.71 / $141.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $100.00 / $151.36
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $79.43 / $302.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $58.88 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $102.33 / $151.36
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $302.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $97.72 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $70.79 / $151.36