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

New York 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?

$60.26

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $60.26 for this service. The price depends on where it is billed: about $60.26 from a physician practice, and about $74.13 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$60.26$47.86 to $85.11
FacilityA hospital or hospital-owned outpatient department$74.13$74.13 to $75.86

How much rates vary

Facilitymedian $74 · 10th to 90th $32 to $85Professionalmedian $60 · 10th to 90th $34 to $100
$0.1$1$10$100facility $74professional $60

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
$31.62
Median
$74.13
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$63.10
Typical High
$97.72
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.03
Typical High
$26.92
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
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$61.66
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$60.26
Typical High
$125.89
United
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$63.10
Typical High
$131.83
Univera
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$58.88
Typical High
$61.66
Univera
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$58.88
Typical High
$100.00

Where New York sits

The same service costs 1.9 times more in South Dakota than in Louisiana. 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.

New York· 42nd of 51

$60.26

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.