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Michigan 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 $195 · 10th–90th $195–$1950%50%$195Professionalmedian $120 · 10th–90th $71–$1950%10%20%10th90th$120$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $128.82 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $223.87
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $169.82 / $199.53
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $72.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $75.86 / $95.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $100.00 / $147.91