Tynbil: Know the *real* price for healthcare services

Missouri 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

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $70.68 / $84.00	Professional	$12.00	$70.68	$84.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.75 / $6.77 / $13.59	Professional	$5.75	$6.77	$13.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.55 / $11.55 / $11.55	Professional	$11.55	$11.55	$11.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.23 / $81.44 / $152.00	Facility	$22.23	$81.44	$152.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.50 / $20.39 / $91.15	Professional	$13.50	$20.39	$91.15
United Facility/Professional Professional Modifier Low / Median / High Price $13.50 / $18.89 / $98.80	Professional	$13.50	$18.89	$98.80