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Sperm Readiness Test For Male Fertility

Kentucky 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?

$19.05

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $19.05 for this service. The price depends on where it is billed: about $4.90 from a physician practice, and about $39.81 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 6 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$4.90$4.37 to $28.84
FacilityA hospital or hospital-owned outpatient department$39.81$25.70 to $75.86

How much rates vary

Facilitymedian $40 · 10th to 90th $26 to $76Professionalmedian $5 · 10th to 90th $4 to $36
$10$100$1K$10Kfacility $40professional $5

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
$25.70
Median
$39.81
Typical High
$75.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$28.84
Typical High
$43.65
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$4.37
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$4.68
CareSource
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$478.63
Typical High
$46,773.51
CareSource
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$42.66
Typical High
$588.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$24.55
Median
$45.71
Typical High
$67.61
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$151.36
Typical High
$151.36
Molina
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$31.62
Typical High
$38.02
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$19.05
Typical High
$31.62

Where Kentucky 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.

Kentucky· 51st of 51

$19.05

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.