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Georgia 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
$20.89 / $56.23 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $23.99 / $30.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $31.62 / $40.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.37 / $31.62 / $31.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $69.18 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $38.02 / $47.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $36.31 / $40.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.38 / $28.18 / $31.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $19.05 / $45.71