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Monthly Kidney Disease Management, Adult Patient

Ohio 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 October 2026.

How much does Monthly Kidney Disease Management, Adult Patient cost?

$275

Typical physician fee. In Ohio, October 2026.

Insurers have agreed to pay about $275 for this service. Most negotiated rates run $224 to $331.

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 10 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $282 · 10th to 90th $282 to $603Professionalmedian $275 · 10th to 90th $209 to $437
$200$500facility $282professional $275

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$281.84
Median
$281.84
Typical High
$602.56
Aetna
Setting
Professional
Modifier
None
Typical Low
$281.84
Median
$281.84
Typical High
$537.03
Ambetter
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$281.84
Typical High
$302.00
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$223.87
Typical High
$398.11
Aultcare
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
CareSource
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$309.03
Typical High
$436.52
Cigna
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$229.09
Typical High
$436.52
Medical Mutual of Ohio
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$234.42
Typical High
$436.52
Molina
Setting
Professional
Modifier
None
Typical Low
$245.47
Median
$302.00
Typical High
$478.63
SummaCare
Setting
Professional
Modifier
None
Typical Low
$316.23
Median
$316.23
Typical High
$371.54
United
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$223.87
Typical High
$407.38

Where Ohio sits

The same service costs 2.8 times more in Alaska than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Ohio· 42nd of 51

$275

AK $661NY $234

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.