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Iowa 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
$14.10 / $76.00 / $94.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.55 / $25.79 / $105.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.40 / $76.00 / $145.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.02 / $31.05 / $91.15
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.02 / $23.89 / $35.13
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.48 / $23.89 / $38.26
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $91.20 / $157.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.50 / $25.50 / $40.79