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

South Carolina 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?

$15.49

Typical physician fee. In South Carolina, October 2026.

Insurers have agreed to pay about $15.49 for this service. Most negotiated rates run $13.80 to $81.28.

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 $81 · 10th to 90th $14 to $102Professionalmedian $15 · 10th to 90th $12 to $81
$10$20$50$100facility $81professional $15

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
$81.28
Median
$81.28
Typical High
$81.28
Aetna
Setting
Professional
Modifier
None
Typical Low
$16.60
Median
$81.28
Typical High
$81.28
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$8.32
Median
$40.74
Typical High
$40.74
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$3.31
Median
$16.22
Typical High
$16.22
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$2.45
Median
$12.02
Typical High
$12.02
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$1.66
Median
$8.13
Typical High
$8.13
BCBS South Carolina
Setting
Professional
Modifier
None
Typical Low
$17.38
Median
$154.88
Typical High
$239.88
Cigna
Setting
Professional
Modifier
None
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Medcost
Setting
Facility
Modifier
None
Typical Low
$14.45
Median
$81.28
Typical High
$102.33
Medcost
Setting
Professional
Modifier
None
Typical Low
$13.80
Median
$13.80
Typical High
$15.49
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
United
Setting
Professional
Modifier
None
Typical Low
$12.02
Median
$15.14
Typical High
$21.88
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$6.92
Median
$6.92
Typical High
$9.77

Where South Carolina 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.

South Carolina· 28th of 51

$15.49

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.