Dialysis services, 2-3 physician visits per month (20 years or older)
Medicare pricing data for 10,097 providers across 52 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Dialysis services, 2-3 physician visits per month (20 years or older) (HCPCS code 90961) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $290.19, but hospitals typically charge $642.49 — a 2.2x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $290.19, your out-of-pocket cost would be approximately $58.04. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $229.25 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $369 | $1,426 | 8 | 1,035 | +27.3% |
| District of Columbia | $320 | $631 | 41 | 3,976 | +10.3% |
| New York | $316 | $715 | 631 | 22,304 | +9.0% |
| New Jersey | $309 | $662 | 354 | 12,419 | +6.4% |
| California | $309 | $625 | 947 | 64,838 | +6.3% |
| Connecticut | $307 | $729 | 103 | 3,092 | +5.7% |
| Massachusetts | $306 | $861 | 191 | 10,161 | +5.5% |
| Maryland | $306 | $622 | 209 | 9,640 | +5.4% |
| Illinois | $297 | $675 | 423 | 16,602 | +2.2% |
| New Hampshire | $295 | $859 | 29 | 1,110 | +1.8% |
| Washington | $295 | $654 | 162 | 12,738 | +1.5% |
| Rhode Island | $294 | $637 | 31 | 549 | +1.3% |
| Florida | $290 | $582 | 645 | 25,741 | +0.1% |
| Colorado | $290 | $697 | 144 | 4,939 | -0.1% |
| Oregon | $289 | $753 | 108 | 5,496 | -0.4% |
| Pennsylvania | $288 | $547 | 439 | 12,949 | -0.9% |
| Michigan | $287 | $557 | 358 | 12,687 | -1.0% |
| Virginia | $287 | $594 | 250 | 8,414 | -1.2% |
| Montana | $287 | $655 | 24 | 1,189 | -1.3% |
| Texas | $285 | $619 | 847 | 38,180 | -1.8% |
| Maine | $284 | $661 | 39 | 1,246 | -2.2% |
| New Mexico | $283 | $655 | 64 | 4,358 | -2.4% |
| Minnesota | $283 | $839 | 147 | 10,654 | -2.4% |
| North Dakota | $283 | $847 | 34 | 1,671 | -2.6% |
| South Dakota | $281 | $626 | 35 | 2,806 | -3.0% |
| Georgia | $281 | $620 | 367 | 14,688 | -3.3% |
| Wyoming | $280 | $770 | 12 | 610 | -3.5% |
| West Virginia | $279 | $572 | 60 | 2,301 | -3.9% |
| Vermont | $279 | $1,219 | 6 | 419 | -4.0% |
| Missouri | $278 | $586 | 200 | 11,375 | -4.1% |
| Ohio | $277 | $560 | 421 | 11,385 | -4.4% |
| Louisiana | $277 | $546 | 185 | 8,226 | -4.5% |
| Delaware | $277 | $585 | 53 | 1,651 | -4.6% |
| Hawaii | $277 | $637 | 58 | 2,947 | -4.7% |
| Nevada | $276 | $759 | 121 | 3,271 | -4.9% |
| Kentucky | $275 | $524 | 158 | 4,545 | -5.2% |
| South Carolina | $275 | $568 | 180 | 6,467 | -5.3% |
| Arizona | $275 | $607 | 208 | 8,109 | -5.3% |
| Idaho | $274 | $543 | 37 | 2,165 | -5.4% |
| Indiana | $274 | $560 | 224 | 8,975 | -5.5% |
| Kansas | $274 | $549 | 51 | 2,515 | -5.7% |
| North Carolina | $273 | $688 | 377 | 10,382 | -5.8% |
| Oklahoma | $273 | $549 | 104 | 6,973 | -6.0% |
| Iowa | $272 | $718 | 70 | 2,837 | -6.1% |
| Wisconsin | $272 | $1,170 | 153 | 5,477 | -6.2% |
| Puerto Rico | $272 | $284 | 76 | 1,584 | -6.4% |
| Utah | $271 | $650 | 77 | 2,040 | -6.8% |
| Tennessee | $270 | $707 | 212 | 7,731 | -6.9% |
| Mississippi | $270 | $717 | 100 | 5,563 | -7.0% |
| Nebraska | $269 | $709 | 49 | 2,918 | -7.4% |
| Alabama | $268 | $503 | 172 | 5,939 | -7.5% |
| Arkansas | $265 | $492 | 78 | 4,715 | -8.7% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber