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Sperm Readiness Test For Male Fertility

New Jersey 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?

$26.92

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $26.92 for this service. The price depends on where it is billed: about $23.44 from a physician practice, and about $52.48 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 5 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$23.44$20.89 to $26.92
FacilityA hospital or hospital-owned outpatient department$52.48$41.69 to $145

How much rates vary

Facilitymedian $52 · 10th to 90th $32 to $316Professionalmedian $23 · 10th to 90th $17 to $42
$100$1K$10Kfacility $52professional $23

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
$40.74
Median
$41.69
Typical High
$194.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$16.60
Median
$25.12
Typical High
$41.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$70.79
Typical High
$74.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$16.60
Median
$38.02
Typical High
$47.86
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$14.79
Typical High
$18.62
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$11,481.54
Typical High
$25,118.86
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$21.88
Typical High
$21.88
United
Setting
Facility
Modifier
Global
Typical Low
$14.79
Median
$31.62
Typical High
$64.57
United
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$19.05
Typical High
$31.62

Where New Jersey 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.

New Jersey· 28th of 51

$26.92

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.