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MDPP Core Maintenance, Months 7-9, Under 5% Weight Loss

California rates for HCPCS G9876

Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM). A core maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 7 through 12 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for maintenance sessions. The beneficiary did not achieve at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9

Rates data updated July 2026.

How much does MDPP Core Maintenance, Months 7-9, Under 5% Weight Loss cost?

$16.60

Typical negotiated rate. In California, July 2026.

Insurers have agreed to pay about $16.60 for this service. The price depends on where it is billed: about $15.85 from a physician practice, and about $20.89 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$15.85$12.30 to $63.10
FacilityA hospital or hospital-owned outpatient department$20.89$14.79 to $70.79

How much rates vary

Facilitymedian $21 · 10th to 90th $12 to $91Professionalmedian $16 · 10th to 90th $11 to $78
$10$20$50$100$200facility $21professional $16

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$12.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$16.60
Typical High
$77.62
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.75
Median
$14.45
Typical High
$48.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$14.45
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$257.04
Typical High
$831.76
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$91.20
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$117.49
Typical High
$117.49
Providence
Setting
Facility
Modifier
Global
Typical Low
$12.30
Median
$19.95
Typical High
$91.20
Providence
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$13.18
United
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$14.13
Typical High
$41.69
United
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$16.22
Typical High
$38.90

Where California sits

The same service costs 5.8 times more in South Dakota than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

California· 36th of 51

$16.60

SD $75.86HI $13.18

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.