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Monthly Kidney Disease Management, Adult Patient

Illinois 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.

Facilitymedian $372 · 10th–90th $372$1,0230%50%90th$372Professionalmedian $331 · 10th–90th $224$5250%20%10th90th$331$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$302.00
Typical High
$512.86
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$295.12
Typical High
$398.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$1,023.29
Typical High
$1,348.96
BCBS
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$331.13
Typical High
$446.68
Cigna
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$363.08
Typical High
$575.44
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$562.34
Typical High
$776.25
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$363.08
Typical High
$389.05
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$407.38
United
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$323.59
Typical High
$660.69