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

Indiana 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?

$19.05

Typical negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $19.05 for this service. The price depends on where it is billed: about $19.05 from a physician practice, and about $75.86 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 4 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed by	Who charges it	Typical	Range
Physician practiceA doctor's office, clinic or independent provider	A doctor's office, clinic or independent provider	$19.05	$13.18 to $72.44
FacilityA hospital or hospital-owned outpatient department	A hospital or hospital-owned outpatient department	$75.86	$15.14 to $79.43

How much rates vary

Facilitymedian $76 · 10th to 90th $15 to $79Professionalmedian $19 · 10th to 90th $11 to $76

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	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier Global Typical Low $15.14 Median $75.86 Typical High $79.43	Facility	Global	$15.14	$75.86	$79.43
Aetna Setting Professional Modifier Global Typical Low $11.48 Median $56.23 Typical High $77.62	Professional	Global	$11.48	$56.23	$77.62
Anthem BCBS Setting Professional Modifier Global Typical Low $0.02 Median $6.76 Typical High $29.51	Professional	Global	$0.02	$6.76	$29.51
Cigna Setting Facility Modifier Global Typical Low $12.02 Median $12.88 Typical High $19.05	Facility	Global	$12.02	$12.88	$19.05
Cigna Setting Professional Modifier Global Typical Low $12.02 Median $12.02 Typical High $12.02	Professional	Global	$12.02	$12.02	$12.02
United Setting Facility Modifier Global Typical Low $10.47 Median $10.47 Typical High $10.47	Facility	Global	$10.47	$10.47	$10.47
United Setting Professional Modifier Global Typical Low $12.88 Median $15.85 Typical High $25.12	Professional	Global	$12.88	$15.85	$25.12

Where Indiana 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.

Indiana· 17th of 51

$19.05

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.