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California rates for HCPCS G9875

Nine 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 $120 · 10th–90th $74–$3240%10%20%10th90th$120Professionalmedian $102 · 10th–90th $71–$2000%10%20%10th90th$102$0.0$0.2$2.0$20.0$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
$72.44 / $72.44 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $107.15 / $194.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $85.11 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $87.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $257.04 / $831.76
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $537.03
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $707.95 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $117.49 / $234.42
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $97.72 / $181.97