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

Idaho 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?

$17.78

Typical physician fee. In Idaho, July 2026.

Insurers have agreed to pay about $17.78 for this service. Most negotiated rates run $12.30 to $63.10.

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.

How much rates vary

Facilitymedian $22 · 10th to 90th $13 to $93Professionalmedian $17 · 10th to 90th $11 to $71
$10$20$50$100$200facility $22professional $17

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
$12.88
Median
$12.88
Typical High
$12.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$16.22
Typical High
$70.79
BCBS
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$20.42
Typical High
$21.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$12.30
Median
$25.12
Typical High
$102.33
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$77.62
Typical High
$3,890.45
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$16.60
Median
$20.89
Typical High
$33.11
Select Health
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$77.62
Typical High
$95.50
United
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$20.42
Typical High
$27.54

Where Idaho 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.

Idaho· 25th of 51

$17.78

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.