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Monthly Kidney Disease Management, Adult Patient

Montana 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?

$295

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $295 for this service. The price depends on where it is billed: about $295 from a physician practice, and about $468 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 6 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$295$224 to $339
FacilityA hospital or hospital-owned outpatient department$468$380 to $501

How much rates vary

Facilitymedian $468 · 10th to 90th $309 to $562Professionalmedian $295 · 10th to 90th $62 to $490
$50.0$100.0$200.0$500.0$1.0Kfacility $468professional $295

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
Professional
Modifier
Global
Typical Low
$61.66
Median
$295.12
Typical High
$446.68
BCBS
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$363.08
Typical High
$870.96
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$501.19
Typical High
$512.86
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$501.19
Typical High
$512.86
Providence
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$389.05
Typical High
$630.96
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$467.74
Typical High
$776.25
United
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$389.05
Typical High
$501.19

Where Montana 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.

Montana $295 · 33rd 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.