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Minnesota 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
$28.84 / $28.84 / $28.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $25.12 / $37.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.90 / $31.62 / $31.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $31.62 / $31.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $123.03 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $45.71 / $61.66
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $117.49 / $229.09
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $60.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $50.12 / $151.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $19.05 / $67.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $31.62 / $38.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $31.62 / $69.18