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Alaska rates for HCPCS G9877

Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 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 10-12

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.39 / $72.20 / $103.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.55 / $11.55 / $11.55
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.70 / $103.36 / $144.69
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.97 / $19.95 / $20.38
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.70 / $56.70 / $3,495.87
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.51 / $52.92 / $74.76
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.00 / $103.36 / $144.69
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.55 / $16.07 / $2,400,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.98 / $30.00 / $112.50