Tynbil: Know the *real* price for healthcare services

Rhode Island 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

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.00 / $72.00 / $72.00	Facility	$72.00	$72.00	$72.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $56.40 / $72.00	Professional	$48.00	$56.40	$72.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $176.13 / $176.13 / $176.13	Facility	$176.13	$176.13	$176.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.15 / $66.78 / $66.78	Professional	$49.15	$66.78	$66.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.92 / $45.92 / $45.92	Professional	$45.92	$45.92	$45.92
United Facility/Professional Professional Modifier Low / Median / High Price $56.70 / $72.00 / $143.93	Professional	$56.70	$72.00	$143.93