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

New York 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?

$12.30

Typical negotiated rate. In New York, October 2026.

Insurers have agreed to pay about $12.30 for this service. The price depends on where it is billed: about $12.30 from a physician practice, and about $14.79 from a hospital or other facility.

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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$12.30$10.96 to $14.79
FacilityA hospital or hospital-owned outpatient department$14.79$12.88 to $14.79

How much rates vary

Facilitymedian $15 · 10th to 90th $8 to $45Professionalmedian $12 · 10th to 90th $8 to $19
$10$20$50facility $15professional $12

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
$7.94
Median
$13.18
Typical High
$56.23
Aetna
Setting
Professional
Modifier
None
Typical Low
$7.94
Median
$7.94
Typical High
$56.23
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$3.98
Median
$3.98
Typical High
$28.18
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$1.58
Median
$1.58
Typical High
$11.22
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$1.20
Median
$1.20
Typical High
$8.32
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.79
Median
$0.79
Typical High
$5.62
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$5.13
Median
$6.76
Typical High
$17.38
Cigna
Setting
Facility
Modifier
None
Typical Low
$19.05
Median
$19.05
Typical High
$19.05
Cigna
Setting
Professional
Modifier
None
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Excellus BCBS
Setting
Professional
Modifier
None
Typical Low
$10.96
Median
$13.18
Typical High
$15.49
United
Setting
Professional
Modifier
None
Typical Low
$10.00
Median
$12.88
Typical High
$22.39
Univera
Setting
Facility
Modifier
None
Typical Low
$12.88
Median
$14.79
Typical High
$14.79
Univera
Setting
Professional
Modifier
None
Typical Low
$7.76
Median
$13.18
Typical High
$15.49

Where New York 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 York· 47th of 51

$12.30

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.