Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
DIALYSIS PROCEDURE AT A MEDICARE CERTIFIED ESRD FACILITY FOR ACUTE KIDNEY INJURY WITHOUT ESRD
Custer, SD
See all hospitals reporting HCPCS G0491 →Price type
Monument Health Network Inc’s median price of $628 is 6% below the median hospital's median price ($671), higher than 45% of the 370 hospitals reporting HCPCS G0491. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 10 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare uhc mcr adv percent of total billed charges · outpatientfrom % of charges | $166 | $166 | — | — | — | $166 – $166 |
| 2 | Medica medica mcr adv percent of total billed charges · outpatientfrom % of charges | $170 | $170 | — | — | — | $170 – $170 |
| 3 | Wellmark bcbs wellmark mcr adv percent of total billed charges · outpatientfrom % of charges | $170 | $170 | — | — | — | $170 – $170 |
| 4 | Medica medica mcaid percent of total billed charges · outpatientfrom % of charges | $221 | $221 | — | — | — | $221 – $221 |
| 5 | Wellmark bcbs wellmark - all other plans percent of total billed charges · outpatientfrom % of charges | $599 | $599 | — | — | — | $599 – $599 |
| 6 | Aetna aetna - all plans percent of total billed charges · outpatientfrom % of charges | $632 | $632 | — | — | — | $632 – $632 |
| 7 | MultiPlan multiplan/phcs - all plans percent of total billed charges · outpatientfrom % of charges | $632 | $632 | — | — | — | $632 – $632 |
| 8 | Medica medica commercial - all other plans percent of total billed charges · outpatientfrom % of charges | $646 | $646 | — | — | — | $646 – $646 |
| 9 | UnitedHealthcare uhc - all other plans percent of total billed charges · outpatientfrom % of charges | $646 | $646 | — | — | — | $646 – $646 |
| 10 | Humana humana commercial - all plans percent of total billed charges · outpatientfrom % of charges | $665 | $665 | — | — | — | $665 – $665 |
Last updated: Sep 1, 2026
See Dialysis treatment for acute kidney failure, not end-stage pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.