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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
$38.90 / $39.81 / $54.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $25.12 / $38.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $35.48 / $48.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $42.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $25.12 / $58.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $45.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.18 / $31.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $19.05 / $31.62