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Monthly Kidney Disease Management, Adult Patient

New Jersey 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?

$275

Typical physician fee. In New Jersey, July 2026.

Insurers have agreed to pay about $275 for this service. Most negotiated rates run $224 to $355.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $245 · 10th to 90th $245 to $525Professionalmedian $275 · 10th to 90th $186 to $447
$50.0$100.0$200.0$500.0$1.0K$2.0Kfacility $245professional $275

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
$245.47
Median
$245.47
Typical High
$524.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$275.42
Typical High
$407.38
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$281.84
Typical High
$323.59
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$478.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$323.59
Typical High
$630.96
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$436.52
Typical High
$616.60
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$512.86
United
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$281.84
Typical High
$562.34

Where New Jersey 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.

New Jersey $275 · 47th 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.