go back

Monthly Kidney Failure Care Management For A Younger Patient

Michigan 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?

$331

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $331 for this service. The price depends on where it is billed: about $331 from a physician practice, and about $380 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$331$302 to $389
FacilityA hospital or hospital-owned outpatient department$380$380 to $380

How much rates vary

Facilitymedian $380 · 10th to 90th $288 to $417Professionalmedian $331 · 10th to 90th $275 to $525
$500facility $380professional $331

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
$380.19
Median
$380.19
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$323.59
Typical High
$407.38
BCBS
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$524.81
BCBS
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$346.74
Typical High
$741.31
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$346.74
Typical High
$758.58
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$331.13
Typical High
$436.52
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$338.84
Typical High
$1,380.38
United
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$245.47
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$338.84
Typical High
$501.19

Where Michigan 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.

Michigan· 28th of 51

$331

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.