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MDPP Core Maintenance, Months 7-9, 5% Weight Loss or More

Illinois rates for HCPCS G9878

Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 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 achieved 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 7-9

Rates data updated July 2026.

How much does MDPP Core Maintenance, Months 7-9, 5% Weight Loss or More cost?

$69.18

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $69.18 for this service. The price depends on where it is billed: about $69.18 from a physician practice, and about $51.29 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$69.18$52.48 to $95.50
FacilityA hospital or hospital-owned outpatient department$51.29$51.29 to $51.29

How much rates vary

Facilitymedian $51 · 10th to 90th $51 to $56Professionalmedian $69 · 10th to 90th $47 to $102
$1.0$10.0$100.0$1.0Kfacility $51professional $69

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. 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
Global
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
Aetna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$69.18
Typical High
$102.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$47.86
Typical High
$47.86
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$346.74
Typical High
$346.74
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$2,511.89
United
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$56.23
Typical High
$56.23
United
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$69.18
Typical High
$112.20

Where Illinois sits

The same service costs 1.9 times more in South Dakota than in Louisiana. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Illinois $69.18 · 14th of 51
SD $102LA $54.95

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.