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Sperm Readiness Test For Male Fertility

Michigan 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?

$30.20

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $30.20 for this service. The price depends on where it is billed: about $25.70 from a physician practice, and about $30.20 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$22.39 to $30.20
FacilityA hospital or hospital-owned outpatient department$30.20$30.20 to $37.15

How much rates vary

Facilitymedian $30 · 10th to 90th $28 to $55Professionalmedian $26 · 10th to 90th $19 to $37
$20$50facility $30professional $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
$30.20
Median
$30.20
Typical High
$54.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$30.20
Typical High
$37.15
BCBS
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
BCBS
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$22.39
Typical High
$22.39
Cigna
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$38.02
Typical High
$47.86
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$32.36
Typical High
$79.43
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$31.62
Typical High
$42.66
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$38.02
United
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$31.62
Typical High
$38.02
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$19.05
Typical High
$31.62

Where Michigan 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.

Michigan· 23rd of 51

$30.20

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.