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Sperm Readiness Test For Male Fertility

New Mexico 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?

$23.44

Typical negotiated rate. In New Mexico, July 2026.

Insurers have agreed to pay about $23.44 for this service. The price depends on where it is billed: about $23.44 from a physician practice, and about $34.67 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 4 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$23.44 to $39.81
FacilityA hospital or hospital-owned outpatient department$34.67$28.18 to $48.98

How much rates vary

Facilitymedian $35 · 10th to 90th $19 to $95Professionalmedian $23 · 10th to 90th $13 to $40
$20$50$100facility $35professional $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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$95.50
Typical High
$109.65
Aetna
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$23.44
Typical High
$39.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$45.71
Providence
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$30.20
Typical High
$39.81
Providence
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
United
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$28.18
Typical High
$47.86
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$25.12

Where New Mexico 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 Mexico· 47th of 51

$23.44

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.