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Monthly Kidney Failure Care Management For A Younger Patient

North Carolina 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?

$389

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $389 for this service. The price depends on where it is billed: about $398 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 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$398$331 to $589
FacilityA hospital or hospital-owned outpatient department$380$324 to $468

How much rates vary

Facilitymedian $380 · 10th to 90th $302 to $589Professionalmedian $398 · 10th to 90th $309 to $741
$500$1Kfacility $380professional $398

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$323.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$323.59
Typical High
$407.38
BCBS
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$436.52
Typical High
$741.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$426.58
Typical High
$741.31
Medcost
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
Medcost
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$380.19
Typical High
$588.84
Medcost
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$724.44
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$436.52
Typical High
$489.78
United
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$316.23
Typical High
$562.34
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$2,344.23
Median
$2,344.23
Typical High
$2,630.27

Where North Carolina 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.

North Carolina· 11th of 51

$389

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.