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Monthly Kidney Failure Care Management For A Younger Patient

Illinois 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?

$339

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $339 for this service. The price depends on where it is billed: about $339 from a physician practice, and about $457 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 6 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$339$302 to $417
FacilityA hospital or hospital-owned outpatient department$457$457 to $933

How much rates vary

Facilitymedian $457 · 10th to 90th $457 to $1,122Professionalmedian $339 · 10th to 90th $275 to $741
$100$200$500$1Kfacility $457professional $339

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
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$316.23
Typical High
$446.68
BCBS
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$1,122.02
Typical High
$1,698.24
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,023.29
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$416.87
Typical High
$645.65
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$758.58
Typical High
$954.99
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$407.38
Typical High
$426.58
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$446.68
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$363.08
Typical High
$588.84

Where Illinois 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.

Illinois· 24th of 51

$339

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.