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North Carolina 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 / $25.12 / $69.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $25.12 / $30.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $70.79 / $100.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.42 / $28.18 / $31.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $50.12 / $83.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $38.02 / $47.86
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $19.05 / $31.62
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.42 / $20.42 / $23.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $31.62 / $38.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $15.85 / $31.62
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $151.36 / $151.36