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Unscheduled or Emergency Dialysis in Hospital Outpatient

Utah rates for HCPCS G0257

Unscheduled or emergency dialysis treatment for an ESRD patient in a hospital outpatient department that is not certified as an ESRD facility

Rates data updated July 2026.

Facilitymedian $1,549 · 10th–90th $1,380$1,5490%50%10th$1,549Professionalmedian $6 · 10th–90th $6$6310%50%90th$6$10.0$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,380.38
Median
$1,548.82
Typical High
$1,548.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5.75
Median
$5.75
Typical High
$630.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$44.67
Typical High
$144.54
Select Health
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$5,011.87
Select Health
Setting
Professional
Modifier
Global
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$5,011.87
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,230.27
Typical High
$1,230.27