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Nebraska 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
$63.10 / $83.18 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $23.99 / $30.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $177.83 / $346.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $47.86 / $51.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $60.26 / $75.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $38.02 / $151.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $19.05 / $34.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $28.18 / $47.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $19.05 / $34.67