How Much Does Dialysis Cost in the US?

The dollar figures

The USRDS (the federal kidney data registry) reports Medicare spending of roughly $100,000 per dialysis patient per year. Over five years, that's about half a million dollars per patient — one of the highest-cost chronic conditions in medicine.

A single in-center hemodialysis session costs Medicare around $250-280 (composite rate plus adjustments). Three sessions weekly at that rate — plus medications, labs, and physician fees — produces the ~$100K/year figure.

For uninsured or self-pay patients, real-world billed prices vary wildly: dialysis centers often charge $500-1,500 per session before negotiation, and many centers have charity programs. No one should skip dialysis over cost — federal law requires emergency treatment and most centers have financial assistance.

• In-center hemodialysis: ~$90,000-100,000/year (Medicare perspective).
• Peritoneal dialysis (home): ~$70,000-80,000/year — lower than in-center because of fewer facility costs.
• Home hemodialysis: similar to PD, ~$70,000-85,000/year.
• Kidney transplant: ~$400,000 first-year, then ~$25,000/year ongoing — cheaper than dialysis by year 3-4, with far better survival.

Why costs matter for patients

Patients on Original Medicare with no supplement face the 20% coinsurance — potentially $18,000-20,000/year out of pocket before any cap. This is why the ESRD Medigap guarantee and Medicare Advantage ESRD plans matter so much.

For people with employer insurance, ESRD coordination means private insurance pays for the first 30 months, then Medicare takes over. Unexpected bills are common when providers bill both — always confirm how your dialysis provider handles the transition.

Financial assistance exists: the American Kidney Fund's financial assistance program, center charity care, and manufacturer patient-assistance programs for medications. Social workers at dialysis centers are trained to help navigate these.

Dialysis & Treatment

US Kidney Care & Costs