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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 October 2026.

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

$288

Typical physician fee. In West Virginia, October 2026.

Insurers have agreed to pay about $288 for this service. Most negotiated rates run $234 to $347.

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.

How much rates vary

Facilitymedian $525 · 10th to 90th $525 to $525Professionalmedian $288 · 10th to 90th $186 to $490
$200$500$1Kfacility $525professional $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
Professional
Modifier
None
Typical Low
$269.15
Median
$288.40
Typical High
$331.13
CareSource
Setting
Professional
Modifier
None
Typical Low
$275.42
Median
$302.00
Typical High
$446.68
Cigna
Setting
Facility
Modifier
None
Typical Low
$524.81
Median
$524.81
Typical High
$524.81
Cigna
Setting
Professional
Modifier
None
Typical Low
$281.84
Median
$288.40
Typical High
$1,513.56
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$316.23
Median
$354.81
Typical High
$549.54
United
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$234.42
Typical High
$389.05

Where West 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.

West Virginia· 35th 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.