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Wisconsin 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 $178 · 10th–90th $79–$4470%10%20%10th90th$178Professionalmedian $141 · 10th–90th $72–$2140%10%20%10th90th$141$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $123.03 / $194.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $134.90 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $588.84 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $154.88 / $263.03
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $173.78 / $234.42
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $169.82 / $251.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $144.54 / $537.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $58.88 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $186.21 / $275.42
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $537.03
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $173.78 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $125.89 / $269.15