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

Pennsylvania 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?

$16.22

Typical physician fee. In Pennsylvania, October 2026.

Insurers have agreed to pay about $16.22 for this service. Most negotiated rates run $12.02 to $63.10.

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.

How much rates vary

Facilitymedian $72 · 10th to 90th $63 to $72Professionalmedian $16 · 10th to 90th $12 to $72
$10$20$50facility $72professional $16

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
$63.10
Median
$72.44
Typical High
$72.44
Aetna
Setting
Professional
Modifier
None
Typical Low
$19.05
Median
$63.10
Typical High
$72.44
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$9.55
Median
$31.62
Typical High
$36.31
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$3.80
Median
$12.88
Typical High
$14.45
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$2.88
Median
$9.55
Typical High
$10.96
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$1.91
Median
$6.31
Typical High
$7.24
Cigna
Setting
Professional
Modifier
None
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Geisinger
Setting
Professional
Modifier
None
Typical Low
$18.62
Median
$18.62
Typical High
$18.62
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$72.44
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$31.62
Median
$31.62
Typical High
$36.31
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$12.88
Median
$12.88
Typical High
$14.45
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$9.55
Median
$9.55
Typical High
$10.96
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$6.31
Median
$6.31
Typical High
$7.24
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$79.43
Typical High
$158.49
United
Setting
Professional
Modifier
None
Typical Low
$12.88
Median
$13.49
Typical High
$19.95

Where Pennsylvania 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.

Pennsylvania· 22nd of 51

$16.22

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.