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Monthly Kidney Disease Management, Adult Patient

New York 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?

$309

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $309 for this service. The price depends on where it is billed: about $309 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 11 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$309$245 to $427
FacilityA hospital or hospital-owned outpatient department$347$309 to $380

How much rates vary

Facilitymedian $347 · 10th to 90th $282 to $537Professionalmedian $309 · 10th to 90th $204 to $589
$50.0$100.0$200.0$500.0$1.0K$2.0Kfacility $347professional $309

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
$281.84
Median
$346.74
Typical High
$537.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$295.12
Typical High
$457.09
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$302.00
Typical High
$338.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$234.42
Typical High
$489.78
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$524.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$354.81
Typical High
$933.25
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$223.87
Typical High
$794.33
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$436.52
Typical High
$630.96
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$316.23
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$316.23
Typical High
$616.60
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$281.84
Typical High
$323.59
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$338.84
Typical High
$776.25
United
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$234.42
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$446.68
Typical High
$1,659.59
Univera
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$275.42
Typical High
$575.44
Univera
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$316.23
Typical High
$630.96

Where New York 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 York $309 · 20th 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.