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Arkansas rates for HCPCS 0255U

Andrology (infertility), sperm-capacitation assessment of ganglioside GM1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.82 / $39.82 / $54.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.96 / $39.82 / $39.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.54 / $23.83 / $47.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.34 / $36.34 / $45.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.44 / $28.44 / $28.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.27 / $18.96 / $31.60