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

North Carolina 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?

$72.44

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $72.44 for this service. The price depends on where it is billed: about $70.79 from a physician practice, and about $93.33 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 6 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$70.79$52.48 to $100
FacilityA hospital or hospital-owned outpatient department$93.33$72.44 to $112

How much rates vary

Facilitymedian $93 · 10th to 90th $55 to $145Professionalmedian $71 · 10th to 90th $49 to $145
$1.0$5.0$20.0$100.0$500.0facility $93professional $71

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$144.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$70.79
Typical High
$100.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$70.79
Typical High
$177.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$47.86
Typical High
$47.86
Medcost
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$93.33
Typical High
$134.90
United
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
United
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$64.57
Typical High
$104.71
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$467.74
Typical High
$467.74

Where North Carolina 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.

North Carolina $72.44 · 11th 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.