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New Mexico 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
$48.98 / $109.65 / $109.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $25.12 / $38.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $45.71
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $30.20 / $39.81
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $31.62 / $31.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.18 / $28.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $13.18 / $19.05