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

Utah 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 physician fee. In Utah, July 2026.

Insurers have agreed to pay about $19.05 for this service. Most negotiated rates run $13.18 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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $19 · 10th to 90th $19 to $19Professionalmedian $19 · 10th to 90th $11 to $76
$10$20$50$100facility $19professional $19

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$19.05
Typical High
$19.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$19.05
Typical High
$75.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$44.67
Typical High
$54.95
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$18.20
Typical High
$23.99
Select Health
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$95.50
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$19.50
Typical High
$20.42
United
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$16.22
Typical High
$25.70

Where Utah 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.

Utah· 13th 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.