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Nebraska 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

Facilitymedian $126 · 10th–90th $60–$2140%10%20%10th90th$126Professionalmedian $79 · 10th–90th $46–$1170%10%20%10th90th$79$0.1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $75.86 / $104.71
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $125.89 / $165.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $50.12 / $50.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $91.20 / $141.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $125.89 / $213.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $112.20 / $363.08
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $91.20 / $131.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $97.72 / $131.83
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.06 / $0.06 / $0.06
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $104.71 / $169.82