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

New York 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?

$15.14

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $15.14 for this service. The price depends on where it is billed: about $15.14 from a physician practice, and about $56.23 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 6 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$15.14$12.02 to $56.23
FacilityA hospital or hospital-owned outpatient department$56.23$19.05 to $56.23

How much rates vary

Facilitymedian $56 · 10th to 90th $8 to $63Professionalmedian $15 · 10th to 90th $8 to $72
$0.1$1$10$100facility $56professional $15

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
$7.94
Median
$56.23
Typical High
$63.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$16.60
Typical High
$72.44
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.03
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
$12.02
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$15.49
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$15.14
Typical High
$31.62
United
Setting
Facility
Modifier
Global
Typical Low
$15.14
Median
$15.14
Typical High
$15.14
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$15.14
Typical High
$38.02
Univera
Setting
Facility
Modifier
Global
Typical Low
$11.22
Median
$14.79
Typical High
$15.49
Univera
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$14.79
Typical High
$25.12

Where New York 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.

New York· 45th of 51

$15.14

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.