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Monthly Kidney Disease Management, Adult Patient

Florida rates for HCPCS 90961

This covers a month of ongoing outpatient management for an adult with end-stage kidney disease, including a defined number of in-person check-ins with the treating clinician during that month along with related care coordination. It reflects one of several tiers of this monthly service that differ by how many in-person visits occurred.

Rates data updated July 2026.

How much does Monthly Kidney Disease Management, Adult Patient cost?

$288

Typical negotiated rate. In Florida, July 2026.

Insurers have agreed to pay about $288 for this service. The price depends on where it is billed: about $288 from a physician practice, and about $457 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 8 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$288$234 to $347
FacilityA hospital or hospital-owned outpatient department$457$288 to $525

How much rates vary

Facilitymedian $457 · 10th to 90th $204 to $525Professionalmedian $288 · 10th to 90th $191 to $490
$50.0$100.0$200.0$500.0$1.0Kfacility $457professional $288

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. 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
Global
Typical Low
$501.19
Median
$501.19
Typical High
$501.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$288.40
Typical High
$501.19
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$302.00
Typical High
$512.86
AvMed
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$204.17
Typical High
$213.80
AvMed
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$269.15
Typical High
$331.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$707.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$323.59
Typical High
$562.34
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$234.42
Typical High
$371.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$36.31
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$295.12
Typical High
$457.09
United
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$257.04
Typical High
$489.78
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$323.59

Where Florida sits

The same service costs 2.1 times more in Minnesota than in Vermont. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Florida $288 · 40th of 51
MN $501VT $240

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.