go back

Nebraska 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

Facilitymedian $91 · 10th–90th $15–$1510%10%20%10th90th$91Professionalmedian $30 · 10th–90th $11–$780%20%10th90th$30$0.0$0.1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $51.29 / $77.62
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $125.89 / $165.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.59 / $12.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $22.91 / $89.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $87.10 / $147.91
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $26.92 / $91.20
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $22.91 / $33.88
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $24.55 / $33.88
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $25.70 / $39.81