go back

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

Kentucky 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 Kentucky, July 2026.

Insurers have agreed to pay about $16.60 for this service. The price depends on where it is billed: about $16.22 from a physician practice, and about $19.05 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 5 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$16.22$13.18 to $70.79
FacilityA hospital or hospital-owned outpatient department$19.05$19.05 to $79.43

How much rates vary

Facilitymedian $19 · 10th to 90th $19 to $79Professionalmedian $16 · 10th to 90th $11 to $76
$10$20$50$100facility $19professional $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
$74.13
Median
$79.43
Typical High
$79.43
Aetna
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$16.60
Typical High
$75.86
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.13
Median
$6.76
Typical High
$6.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$19.05
Typical High
$19.05
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$67.61
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$44.67
Typical High
$44.67
United
Setting
Facility
Modifier
Global
Typical Low
$18.20
Median
$18.20
Typical High
$18.20
United
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$15.85
Typical High
$29.51

Where Kentucky 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.

Kentucky· 34th 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.