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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 October 2026.

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

$309

Typical negotiated rate. In Virginia, October 2026.

Insurers have agreed to pay about $309 for this service. The price depends on where it is billed: about $302 from a physician practice, and about $347 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$302$269 to $339
FacilityA hospital or hospital-owned outpatient department$347$257 to $603

How much rates vary

Facilitymedian $347 · 10th to 90th $219 to $10,233Professionalmedian $302 · 10th to 90th $245 to $380
$200$500$1K$2K$5K$10Kfacility $347professional $302

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$251.19
Median
$251.19
Typical High
$275.42
Aetna
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$275.42
Typical High
$371.54
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$316.23
Typical High
$380.19
CareFirst
Setting
Professional
Modifier
None
Typical Low
$302.00
Median
$338.84
Typical High
$389.05
Cigna
Setting
Facility
Modifier
None
Typical Low
$602.56
Median
$602.56
Typical High
$691.83
Cigna
Setting
Professional
Modifier
None
Typical Low
$245.47
Median
$295.12
Typical High
$380.19
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$302.00
Median
$338.84
Typical High
$446.68
Medcost
Setting
Professional
Modifier
None
Typical Low
$275.42
Median
$346.74
Typical High
$346.74
Medcost
Setting
Facility
Modifier
None
Typical Low
$331.13
Median
$331.13
Typical High
$436.52
Medcost
Setting
Professional
Modifier
None
Typical Low
$181.97
Median
$181.97
Typical High
$263.03
Sentara
Setting
Facility
Modifier
None
Typical Low
$213.80
Median
$346.74
Typical High
$10,232.93
Sentara
Setting
Professional
Modifier
None
Typical Low
$245.47
Median
$281.84
Typical High
$436.52
United
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$223.87
Typical High
$371.54

Where Virginia 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.

Virginia· 26th of 51

$309

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.