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Monthly Kidney Failure Care Management For A Younger Patient

New York 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?

$355

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $355 for this service. The price depends on where it is billed: about $355 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 9 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$355$288 to $537
FacilityA hospital or hospital-owned outpatient department$380$347 to $417

How much rates vary

Facilitymedian $380 · 10th to 90th $316 to $603Professionalmedian $355 · 10th to 90th $245 to $851
$200$500$1K$2Kfacility $380professional $355

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
$316.23
Median
$380.19
Typical High
$602.56
Aetna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$316.23
Typical High
$426.58
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$263.03
Typical High
$575.44
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$467.74
Typical High
$467.74
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$467.74
Typical High
$467.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$416.87
Typical High
$1,023.29
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$257.04
Typical High
$870.96
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$467.74
Typical High
$707.95
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$346.74
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$354.81
Typical High
$691.83
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$416.87
Typical High
$851.14
United
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
United
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$489.78
Typical High
$1,905.46
Univera
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$407.38
Typical High
$707.95
Univera
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$346.74
Typical High
$794.33

Where New York 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.

New York· 20th of 51

$355

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.