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Connecticut 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
$31.62 / $31.62 / $69.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $19.95 / $30.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $52.48 / $85.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.37 / $13.80 / $23.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $20.42 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $45.71
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $14.79 / $18.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $23.44 / $54.95