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Texas 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 $132 · 10th–90th $76–$3240%10%10th90th$132Professionalmedian $120 · 10th–90th $71–$1910%20%10th90th$120$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $128.82 / $190.55
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
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
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $263.03
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $128.82 / $190.55
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $398.11 / $398.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $257.04
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $83.18 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $97.72 / $158.49
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $190.55 / $239.88