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Washington, DC 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
$22.91 / $22.91 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $23.99 / $25.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $53.70 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $45.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $19.05 / $39.81