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Monthly Kidney Disease Management, Adult Patient

West 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?

$288

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $288 for this service. The price depends on where it is billed: about $288 from a physician practice, and about $372 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 5 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$288$251 to $339
FacilityA hospital or hospital-owned outpatient department$372$302 to $525

How much rates vary

Facilitymedian $372 · 10th to 90th $275 to $525Professionalmedian $288 · 10th to 90th $209 to $479
$100$200$500facility $372professional $288

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
Professional
Modifier
Global
Typical Low
$208.93
Median
$288.40
Typical High
$478.63
CareSource
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$309.03
Typical High
$389.05
CareSource
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$295.12
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$524.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$346.74
Typical High
$1,513.56
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$354.81
Typical High
$549.54
United
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$257.04
Typical High
$371.54

Where West Virginia 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.

West Virginia· 41st of 51

$288

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.