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Monthly Kidney Disease Management, Adult Patient

Tennessee 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?

$302

Typical negotiated rate. In Tennessee, July 2026.

Insurers have agreed to pay about $302 for this service. The price depends on where it is billed: about $302 from a physician practice, and about $1,862 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$302$269 to $363
FacilityA hospital or hospital-owned outpatient department$1,862$1,862 to $1,862

How much rates vary

Facilitymedian $1,862 · 10th to 90th $575 to $1,862Professionalmedian $302 · 10th to 90th $224 to $537
$100$200$500$1Kfacility $1,862professional $302

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. 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
Global
Typical Low
$575.44
Median
$575.44
Typical High
$575.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$302.00
Typical High
$512.86
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$281.84
Typical High
$389.05
BCBS
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$331.13
Typical High
$588.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$316.23
Typical High
$549.54
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$1,862.09
Typical High
$1,862.09
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,905.46
Median
$2,398.83
Typical High
$2,398.83
United
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
United
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$269.15
Typical High
$457.09

Where Tennessee sits

The same service costs 2.1 times more in Minnesota than in Vermont. 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.

Tennessee· 27th of 51

$302

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.