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Monthly Kidney Failure Care Management For A Younger Patient

Kentucky 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?

$302

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $302 for this service. The price depends on where it is billed: about $302 from a physician practice, and about $490 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$302$269 to $324
FacilityA hospital or hospital-owned outpatient department$490$331 to $562

How much rates vary

Facilitymedian $490 · 10th to 90th $316 to $562Professionalmedian $302 · 10th to 90th $234 to $417
$200$500$1Kfacility $490professional $302

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
$316.23
Median
$316.23
Typical High
$323.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$309.03
Typical High
$354.81
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$269.15
Typical High
$389.05
CareSource
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$346.74
Typical High
$489.78
CareSource
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$380.19
Typical High
$478.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$407.38
Typical High
$1,621.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$354.81
United
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$309.03
Typical High
$537.03

Where Kentucky 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.

Kentucky· 50th of 51

$302

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.