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Montana 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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.81 / $84.60 / $181.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.44 / $131.44 / $131.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.73 / $68.73 / $131.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.30 / $108.26 / $204.37
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.73 / $131.44 / $2,400,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.02 / $145.86 / $171.91