go back

Monthly Kidney Disease Management, Adult Patient

Iowa 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?

$339

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $339 for this service. The price depends on where it is billed: about $331 from a physician practice, and about $407 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$331$288 to $479
FacilityA hospital or hospital-owned outpatient department$407$295 to $550

How much rates vary

Facilitymedian $407 · 10th to 90th $269 to $646Professionalmedian $331 · 10th to 90th $245 to $708
$100.0$200.0$500.0$1.0Kfacility $407professional $331

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
$407.38
Median
$407.38
Typical High
$407.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$302.00
Typical High
$616.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$489.78
Typical High
$776.25
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$616.60
Typical High
$776.25
Medica
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$407.38
Typical High
$660.69
Medica
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$436.52
Typical High
$1,905.46
Midlands
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$549.54
Typical High
$794.33
Midlands
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$478.63
Typical High
$794.33
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$562.34
Typical High
$707.95
United
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$389.05
Typical High
$676.08
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$549.54
Typical High
$645.65

Where Iowa 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.

Iowa $339 · 8th 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.