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MDPP Core Maintenance, Months 10-12, Under 5% Weight Loss

New Jersey 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

Rates data updated October 2026.

How much does MDPP Core Maintenance, Months 10-12, Under 5% Weight Loss cost?

$13.18

Typical physician fee. In New Jersey, October 2026.

Insurers have agreed to pay about $13.18 for this service. Most negotiated rates run $12.02 to $15.14.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $13 · 10th to 90th $13 to $15Professionalmedian $13 · 10th to 90th $11 to $18
$10$20$50facility $13professional $13

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$13.18
Median
$13.18
Typical High
$15.14
Aetna
Setting
Professional
Modifier
None
Typical Low
$13.18
Median
$13.18
Typical High
$15.14
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$6.61
Median
$6.61
Typical High
$7.59
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$2.63
Median
$2.63
Typical High
$3.02
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$1.95
Median
$1.95
Typical High
$2.24
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$1.32
Median
$1.32
Typical High
$1.51
Cigna
Setting
Professional
Modifier
None
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$18.20
Median
$18.20
Typical High
$22.39
United
Setting
Professional
Modifier
None
Typical Low
$10.47
Median
$12.30
Typical High
$14.79

Where New Jersey sits

The same service costs 4.9 times more in Alaska than in Connecticut. 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 Jersey· 45th of 51

$13.18

AK $56.23CT $11.48

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.