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Monthly Kidney Disease Management, Adult Patient

Michigan 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?

$302

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $302 for this service. The price depends on where it is billed: about $302 from a physician practice, and about $347 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$302$245 to $347
FacilityA hospital or hospital-owned outpatient department$347$347 to $355

How much rates vary

Facilitymedian $347 · 10th to 90th $234 to $380Professionalmedian $302 · 10th to 90th $195 to $479
$50.0$100.0$200.0$500.0$1.0Kfacility $347professional $302

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
$346.74
Median
$346.74
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$302.00
Typical High
$398.11
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$295.12
Typical High
$524.81
BCBS
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$478.63
BCBS
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$512.86
Typical High
$512.86
CareSource
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$354.81
Typical High
$380.19
CareSource
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$371.54
Typical High
$436.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$302.00
Typical High
$676.08
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$316.23
Typical High
$616.60
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$302.00
Typical High
$501.19
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$275.42
Typical High
$1,230.27
United
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$199.53
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$281.84
Typical High
$588.84

Where Michigan 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.

Michigan $302 · 22nd 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.