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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 October 2026.

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

$288

Typical physician fee. In Tennessee, October 2026.

Insurers have agreed to pay about $288 for this service. Most negotiated rates run $257 to $1,072.

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.

How much rates vary

Facilitymedian $575 · 10th to 90th $275 to $692Professionalmedian $288 · 10th to 90th $229 to $2,630
$200$500$1K$2Kfacility $575professional $288

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
$275.42
Median
$275.42
Typical High
$575.44
Aetna
Setting
Professional
Modifier
None
Typical Low
$275.42
Median
$288.40
Typical High
$380.19
Ambetter
Setting
Professional
Modifier
None
Typical Low
$234.42
Median
$275.42
Typical High
$309.03
BCBS Tennessee
Setting
Professional
Modifier
None
Typical Low
$218.78
Median
$257.04
Typical High
$489.78
Cigna
Setting
Facility
Modifier
None
Typical Low
$602.56
Median
$602.56
Typical High
$691.83
Cigna
Setting
Professional
Modifier
None
Typical Low
$234.42
Median
$275.42
Typical High
$426.58
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$1,905.46
Median
$2,630.27
Typical High
$2,630.27
United
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$245.47
Typical High
$478.63

Where Tennessee 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.

Tennessee· 38th of 51

$288

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.