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

Pennsylvania 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?

$64.57

Typical physician fee. In Pennsylvania, October 2026.

Insurers have agreed to pay about $64.57 for this service. Most negotiated rates run $47.86 to $95.50.

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.

How much rates vary

Facilitymedian $98 · 10th to 90th $85 to $98Professionalmedian $65 · 10th to 90th $48 to $98
$50$100$200facility $98professional $65

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
$85.11
Median
$97.72
Typical High
$97.72
Aetna
Setting
Professional
Modifier
None
Typical Low
$67.61
Median
$85.11
Typical High
$97.72
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$33.88
Median
$42.66
Typical High
$47.86
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$13.49
Median
$16.98
Typical High
$19.50
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$10.23
Median
$12.59
Typical High
$14.45
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$6.76
Median
$8.51
Typical High
$9.77
Cigna
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$47.86
Typical High
$47.86
Geisinger
Setting
Professional
Modifier
None
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$97.72
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$42.66
Median
$42.66
Typical High
$47.86
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$16.98
Median
$16.98
Typical High
$19.50
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$12.59
Median
$12.59
Typical High
$14.45
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$8.51
Median
$8.51
Typical High
$9.77
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$104.71
Typical High
$208.93
United
Setting
Professional
Modifier
None
Typical Low
$51.29
Median
$56.23
Typical High
$81.28

Where Pennsylvania 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.

Pennsylvania· 22nd of 51

$64.57

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.