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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
$26.30 / $31.62 / $38.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $23.99 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $37.15 / $39.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $38.02 / $47.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $31.62 / $47.86