Tynbil: Know the *real* price for healthcare services

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

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.11 / $13.11 / $13.11	Facility	$13.11	$13.11	$13.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.19 / $13.20 / $72.80	Professional	$10.19	$13.20	$72.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.66 / $15.66 / $15.66	Facility	$15.66	$15.66	$15.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.55 / $11.55 / $11.55	Professional	$11.55	$11.55	$11.55
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.59 / $17.16 / $18.04	Professional	$14.59	$17.16	$18.04
United Facility/Professional Professional Modifier Low / Median / High Price $10.65 / $15.00 / $28.35	Professional	$10.65	$15.00	$28.35