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

Virginia 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?

$14.45

Typical negotiated rate. In Virginia, October 2026.

Insurers have agreed to pay about $14.45 for this service. The price depends on where it is billed: about $14.45 from a physician practice, and about $18.20 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$14.45$12.02 to $16.60
FacilityA hospital or hospital-owned outpatient department$18.20$15.14 to $26.92

How much rates vary

Facilitymedian $18 · 10th to 90th $13 to $107Professionalmedian $14 · 10th to 90th $12 to $72
$10$100$1K$10Kfacility $18professional $14

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$16.60
Median
$16.60
Typical High
$72.44
Aetna
Setting
Professional
Modifier
None
Typical Low
$16.60
Median
$16.60
Typical High
$72.44
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$8.32
Median
$8.32
Typical High
$36.31
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$3.31
Median
$3.31
Typical High
$14.45
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$2.45
Median
$2.45
Typical High
$10.72
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$1.66
Median
$1.66
Typical High
$7.24
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$4.90
Median
$6.46
Typical High
$6.76
Cigna
Setting
Professional
Modifier
None
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$13.80
Median
$16.60
Typical High
$20.89
Medcost
Setting
Facility
Modifier
None
Typical Low
$12.02
Median
$72.44
Typical High
$107.15
Medcost
Setting
Professional
Modifier
None
Typical Low
$9.33
Median
$13.80
Typical High
$14.13
Sentara
Setting
Facility
Modifier
None
Typical Low
$13.49
Median
$17.78
Typical High
$4,570.88
Sentara
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$14.79
Typical High
$19.95
United
Setting
Professional
Modifier
None
Typical Low
$10.47
Median
$13.18
Typical High
$21.38

Where Virginia 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.

Virginia· 35th of 51

$14.45

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.