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Monthly Kidney Failure Care Management For A Younger Patient

Ohio 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?

$316

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $316 for this service. The price depends on where it is billed: about $316 from a physician practice, and about $525 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 8 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$316$282 to $380
FacilityA hospital or hospital-owned outpatient department$525$316 to $589

How much rates vary

Facilitymedian $525 · 10th to 90th $316 to $589Professionalmedian $316 · 10th to 90th $251 to $457
$50$100$200$500$1Kfacility $525professional $316

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
$588.84
Typical High
$588.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$316.23
Typical High
$389.05
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$323.59
Typical High
$501.19
CareSource
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$346.74
Typical High
$398.11
CareSource
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$380.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$398.11
Typical High
$707.95
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$524.81
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$398.11
Typical High
$645.65
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$407.38
Typical High
$758.58
United
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$323.59
Typical High
$562.34

Where Ohio 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.

Ohio· 47th of 51

$316

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.