OBJECTIVES:  End stage renal failure is expected to become a major health problem  for  Turkey due to aging population and the increasing incidence of chronic diseases with  renal  effects.  It was reported that   end stage renal failure incidence with a need for transplantation has risen from 350 to 847 per million population from  1998 to 2009. In addition,   the number of patients  needing dialysis treatment has also risen from 3069 to 46659 for the same years. Dialysis treatment is predominantly in  private sector in Turkey and as of 2009, 71.5% of total  dialysis treatment was administered by the private sector.  The aim of the study is to calculate the average cost of dialysis seance for Turkey. METHODS:  A Cost model was designed with  main costs including pharmaceutical, medical device, personal, financial, depreciation, tax and other cost. 75 dialysis clinics,  already audited by international independent organizations, were included in the analysis.   RESULTS:  A total of 7.102 and 7.090 patients were treated, 1.018.712 and 1.028.392 seances were administered in the selected clinics in 2009 and 2010, respectively. The total costs were calculated as 166 million TL and 163 million TL in 2009 and 2010. Personel costs had the highest share (35.14% and 35.90%)  followed by pharmaceutical and medical device costs ( 27.16% and 26.20%) for 2009 and 2010, respectively. Average seance costs were calculated as 163.40 TL and 164.07 TL for 2009 and 2010. CONCLUSIONS: The Social Security Institution reimburses 135 or 145 TL  per dialysis seance depending on the treatment. However, as the study results show  this reimbursement rate  is below the real cost. This may cause dialysis center`s not to provide healthcare for government reimbursement agency or going to close due the financial diffuculties. Closing of private centers may efect system especially patients, because of dialysis treatment was administered mostly by private sector.