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Hawaii 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
$26.07 / $29.55 / $37.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.92 / $37.92 / $37.92
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.13 / $33.09 / $39.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.60 / $37.92 / $47.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.27 / $37.92 / $47.40