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Kentucky 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
$25.12 / $43.65 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $25.12 / $30.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.37 / $4.37 / $4.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.37 / $4.37 / $4.68
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $478.63 / $46,773.51
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $42.66 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $50.12 / $50.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $151.36 / $151.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $19.05 / $31.62