Backgrounds: The main aim of this study was to estimate the costs of different dialysis modalities through the analysis of administrative databases in the Macerata and Tolentino hospitals, in Italy. Methods: We retrospectively analyzed two main categories: medical direct costs (all the monetary costs whose consumption is wholly referable to dialysis treatment) and non-medical direct costs (all the costs that make treatment possible but that are outside the medical care sector), related to 2013. Attention was focused on the analysis of the extracorporeal dialysis methods (HD, HDF/AFB, HDF/MID/HFR) and the peritoneal dialysis (APD, CAPD). Results: An analysis overall of economic costs (direct costs + indirect costs) for dialysis treatment, shows that the cost per week for Continuous Ambulatory Peritoneal Dialysis (CAPD) technique is less expensive for health-care budgets, followed by Automated Peritoneal Dialysis (APD). Regarding the extracorporeal dialysis methods, the treatment more affordable is HD. Conclusions: Results obtained confirm that peritoneal dialysis technique is more convenient for health-care budget than extracorporeal dialysis. Furthermore, this study allowed to develop a methodology that could be a reference for similar studies.