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Illinois 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 $76 · 10th–90th $76–$810%50%90th$76Professionalmedian $123 · 10th–90th $71–$1950%20%10th90th$123$1.0$5.0$20.0$100.0$500.0$2.0K

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
$75.86 / $75.86 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $141.25 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $346.74 / $346.74
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $102.33 / $169.82