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Sperm Readiness Test For Male Fertility

Maine 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?

$31.62

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $31.62 for this service. The price depends on where it is billed: about $25.70 from a physician practice, and about $31.62 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$25.70$19.05 to $31.62
FacilityA hospital or hospital-owned outpatient department$31.62$31.62 to $72.44

How much rates vary

Facilitymedian $32 · 10th to 90th $32 to $79Professionalmedian $26 · 10th to 90th $13 to $38
$5$10$20$50$100facility $32professional $26

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
$31.62
Typical High
$79.43
Aetna
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$25.70
Typical High
$25.70
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$14.13
Typical High
$20.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$45.71
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$31.62
Typical High
$38.02
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$79.43
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$25.70
Typical High
$31.62
United
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$31.62
Typical High
$45.71

Where Maine 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.

Maine· 19th of 51

$31.62

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.