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Monthly Kidney Disease Management, Adult Patient

Virginia 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 Virginia, July 2026.

Insurers have agreed to pay about $302 for this service. The price depends on where it is billed: about $295 from a physician practice, and about $316 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 8 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$295$251 to $355
FacilityA hospital or hospital-owned outpatient department$316$275 to $398

How much rates vary

Facilitymedian $316 · 10th to 90th $251 to $501Professionalmedian $295 · 10th to 90th $214 to $457
$50.0$100.0$200.0$500.0$1.0K$2.0Kfacility $316professional $295

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
Professional
Modifier
Global
Typical Low
$190.55
Median
$288.40
Typical High
$380.19
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$363.08
Typical High
$537.03
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$309.03
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
$239.88
Median
$309.03
Typical High
$537.03
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$363.08
Typical High
$512.86
Medcost
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$331.13
Typical High
$389.05
Medcost
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$338.84
Typical High
$512.86
Medcost
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Sentara
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$302.00
Typical High
$478.63
Sentara
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$302.00
Typical High
$478.63
United
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$281.84
Typical High
$478.63

Where Virginia 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.

Virginia $302 · 25th 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.