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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 October 2026.

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

$51.29

Typical negotiated rate. In New York, October 2026.

Insurers have agreed to pay about $51.29 for this service. The price depends on where it is billed: about $51.29 from a physician practice, and about $58.88 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$51.29$45.71 to $58.88
FacilityA hospital or hospital-owned outpatient department$58.88$51.29 to $58.88

How much rates vary

Facilitymedian $59 · 10th to 90th $32 to $76Professionalmedian $51 · 10th to 90th $32 to $74
$50$100$200facility $59professional $51

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$31.62
Median
$52.48
Typical High
$74.13
Aetna
Setting
Professional
Modifier
None
Typical Low
$31.62
Median
$31.62
Typical High
$74.13
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$15.85
Median
$15.85
Typical High
$37.15
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$6.31
Median
$6.31
Typical High
$14.79
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$4.79
Median
$4.79
Typical High
$11.22
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$3.16
Median
$3.16
Typical High
$7.41
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$19.95
Median
$26.92
Typical High
$69.18
Cigna
Setting
Facility
Modifier
None
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Cigna
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$47.86
Typical High
$47.86
Excellus BCBS
Setting
Professional
Modifier
None
Typical Low
$43.65
Median
$52.48
Typical High
$61.66
United
Setting
Professional
Modifier
None
Typical Low
$40.74
Median
$52.48
Typical High
$83.18
Univera
Setting
Facility
Modifier
None
Typical Low
$51.29
Median
$58.88
Typical High
$58.88
Univera
Setting
Professional
Modifier
None
Typical Low
$30.90
Median
$52.48
Typical High
$61.66

Where New York sits

The same service costs 3.0 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.

New York· 46th of 51

$51.29

AK $138CT $46.77

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.