Dialysis costs roughly $800 to $1,900 per week in the United States, depending on how you measure it. The Medicare base payment rate for a single dialysis treatment is $273.82 in 2025, and most patients receive three treatments per week, putting the direct treatment cost around $820 weekly. But total healthcare spending for someone on in-center hemodialysis averages about $99,369 per year, or roughly $1,910 per week, once you factor in related medications, lab work, and hospitalizations.
What you actually pay out of pocket depends heavily on your insurance situation. Here’s how the costs break down and what to realistically expect.
The Base Cost of Each Treatment
Medicare sets a standardized payment rate for each dialysis session through its prospective payment system. For 2025, that base rate is $273.82 per treatment, up slightly from $271.02 in 2024. This bundled payment covers the dialysis procedure itself, standard lab tests, and certain injectable medications administered during treatment. At three sessions per week, that comes to about $821 in direct treatment costs weekly, or roughly $3,560 per month.
That base rate gets adjusted for factors like geographic wage differences and patient characteristics, so the actual reimbursement a facility receives varies. Facilities in high-cost metro areas receive somewhat more, while rural centers receive less. Medicare typically reimburses for 13 to 14 treatments per month, though additional sessions can be covered when medically necessary.
The $273.82 figure only captures what Medicare pays the dialysis facility per session. It doesn’t include physician fees, prescription drugs you take at home, emergency room visits, or hospital stays related to kidney disease. When all of those are added together, the total annual cost for an in-center hemodialysis patient reached $99,369 in 2022, according to the U.S. Renal Data System. That works out to about $7,600 to $8,300 per month in total healthcare expenditures.
What You Pay Out of Pocket With Medicare
Most people on dialysis qualify for Medicare coverage, even if they’re under 65. Once enrolled in Medicare Part B, you’re responsible for 20% of the Medicare-approved amount for each treatment after meeting your annual deductible. At the 2025 base rate, 20% of $273.82 is about $55 per session, or roughly $165 per week for three treatments. Over a full year, that coinsurance alone adds up to around $8,500.
Many patients reduce or eliminate that 20% through supplemental coverage. A Medigap plan, Medicaid (for those who qualify by income), or employer-sponsored insurance can pick up most or all of the coinsurance. Without any supplemental coverage, though, that 20% becomes a significant ongoing expense.
How Private Insurance Changes the Timeline
If you have employer-sponsored health insurance when you start dialysis, there’s a 30-month coordination period during which your private plan remains the primary payer, even after you become eligible for Medicare. During those first 30 months, Medicare acts as secondary insurance, filling in gaps your private plan doesn’t cover.
This matters because private insurance often pays dialysis facilities at higher rates than Medicare, which can affect your cost-sharing depending on your plan’s structure. Your deductible, copay, and out-of-pocket maximum under a private plan may be quite different from the flat 20% coinsurance under Medicare. Some patients find their private coverage more generous during this window; others hit high deductibles quickly. After the 30-month period ends, Medicare becomes your primary payer regardless.
Home Dialysis Costs Less Overall
Peritoneal dialysis, which you perform at home using fluid exchanges through a catheter in your abdomen, carries significantly lower total costs than in-center hemodialysis. A study published in The American Journal of Managed Care found that hemodialysis patients had median annual healthcare costs about $43,500 higher than peritoneal dialysis patients ($173,507 versus $129,997). That gap translates to roughly $835 less per week for peritoneal dialysis.
Home hemodialysis is another option, though it can actually cost more than in-center treatment. The higher price tag comes partly from training costs and the fact that home hemodialysis patients sometimes receive more treatments per month than the standard three-per-week in-center schedule. Still, many patients on home hemodialysis report better quality of life and more flexibility, which may offset the financial difference for some.
Medication Costs Add Up Quickly
Dialysis doesn’t just involve the treatments themselves. Most patients take several prescription medications daily, and the costs can be substantial. Phosphate binders, which prevent dangerous mineral buildup when your kidneys can’t filter phosphorus, are the single most expensive drug category for dialysis patients. Insurance spending on phosphate binders alone averages $3,710 per hemodialysis patient per year, and the cost per person actually using them reaches $5,344 annually.
Medications to treat anemia, manage blood pressure, and supplement vitamins that dialysis strips away add further layers of expense. Some of these drugs are administered during treatment sessions and covered under Medicare Part B’s bundled payment. Others you take at home, falling under Medicare Part D or your prescription drug plan, with their own copays and coverage gaps.
Transportation and Lifestyle Costs
Getting to a dialysis center three times a week creates a real financial burden that’s easy to overlook. Each session lasts three to four hours, and when you add travel time and recovery time afterward, dialysis can consume most of a day. Patients who can’t drive themselves may need medical transport or rideshare services, with costs that range widely based on distance and availability. Those eligible for Medicaid often get transportation covered, but patients without that benefit absorb the cost themselves.
The dietary requirements of kidney disease also carry a modest cost premium. A renal diet tends to run slightly higher than a standard budget diet because it requires specific food choices: higher protein, limited potassium and phosphorus, and restricted sodium. The difference per serving is small, but it narrows your options. Cheaper convenience foods and fast-food meals are often too high in phosphorus or sodium, pushing you toward pricier alternatives.
Why Costs Vary by Location
Where you receive dialysis affects the underlying cost of your care, even if your copay stays the same. Urban dialysis facilities tend to operate more efficiently than rural ones, largely because of volume. Urban centers averaged about 11,000 treatments per year in 2023, compared to roughly 7,700 at rural facilities. That higher volume spreads fixed costs across more patients, lowering the cost per treatment. A 2025 MedPAC analysis found a strong statistical relationship between treatment volume and cost: the more treatments a facility performs, the lower its per-treatment cost.
For patients, this means rural areas may have fewer facilities to choose from, potentially longer drives, and centers operating on thinner margins. It doesn’t necessarily change your out-of-pocket cost directly, since Medicare pays a standardized rate, but it can influence the services and staffing available at your local center.
Total Weekly Cost at a Glance
- Treatment only (Medicare rate): approximately $820 per week for three in-center hemodialysis sessions
- Total healthcare costs (all services): approximately $1,910 per week for in-center hemodialysis patients
- Patient coinsurance under Medicare: roughly $165 per week without supplemental insurance
- Peritoneal dialysis (total costs): approximately $2,500 per month, or about $625 per week
These figures represent averages across the U.S. healthcare system. Your actual costs depend on your insurance coverage, treatment modality, medication needs, and where you live. Patients with strong supplemental coverage may pay very little out of pocket each week, while uninsured or underinsured patients face the full weight of these expenses.