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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.

Facilitymedian $245 · 10th–90th $245$5250%50%90th$245Professionalmedian $275 · 10th–90th $186$4470%10%10th90th$275$50.0$100.0$200.0$500.0$1.0K$2.0K

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

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