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Sperm Readiness Test For Male Fertility

Indiana rates for HCPCS 0255U

Assesses male fertility by examining sperm under a microscope and scoring how many have completed capacitation — the change that makes a sperm able to fertilize an egg. The marker used is ganglioside GM1 on the sperm surface, and the result is reported as a likelihood.

Rates data updated July 2026.

How much does Sperm Readiness Test For Male Fertility cost?

$25.70

Typical negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $25.70 for this service. The price depends on where it is billed: about $21.88 from a physician practice, and about $34.67 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$21.88$5.37 to $25.70
FacilityA hospital or hospital-owned outpatient department$34.67$31.62 to $69.18

How much rates vary

Facilitymedian $35 · 10th to 90th $32 to $95Professionalmedian $22 · 10th to 90th $4 to $32
$5$10$20$50$100$200facility $35professional $22

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$48.98
Typical High
$95.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$25.70
Typical High
$31.62
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$95.50
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$23.99
CareSource
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$457.09
Typical High
$43,651.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$20.42
Median
$52.48
Typical High
$123.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.75
Median
$36.31
Typical High
$45.71
United
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$31.62
Typical High
$36.31
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$19.05
Typical High
$34.67

Where Indiana sits

The same service costs 3.2 times more in South Dakota than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Indiana· 32nd of 51

$25.70

SD $60.26KY $19.05

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.