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Monthly Kidney Failure Care Management For A Younger Patient

Florida rates for HCPCS 90959

This covers a physician's ongoing monthly management of a child or teenager with kidney failure who is on dialysis, including overseeing the dialysis plan, reviewing lab results, and adjusting treatment over the course of a month. It reflects a month in which the physician had a certain number of in-person visits with the patient as part of that oversight. This is a management fee for physician oversight rather than the dialysis treatment itself.

Rates data updated July 2026.

How much does Monthly Kidney Failure Care Management For A Younger Patient cost?

$316

Typical negotiated rate. In Florida, July 2026.

Insurers have agreed to pay about $316 for this service. The price depends on where it is billed: about $316 from a physician practice, and about $550 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 7 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$316$282 to $347
FacilityA hospital or hospital-owned outpatient department$550$257 to $562

How much rates vary

Facilitymedian $550 · 10th to 90th $224 to $871Professionalmedian $316 · 10th to 90th $234 to $417
$50$100$200$500facility $550professional $316

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
$239.88
Median
$316.23
Typical High
$407.38
AvMed
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$223.87
Typical High
$234.42
AvMed
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$316.23
Typical High
$363.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$870.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$380.19
Typical High
$660.69
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$281.84
Typical High
$426.58
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$36.31
Typical High
$426.58
United
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$354.81
Typical High
$575.44
United
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$309.03
Typical High
$549.54
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$346.74

Where Florida sits

The same service costs 2.5 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.

Florida· 45th of 51

$316

MN $741VT $295

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.