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Sperm Readiness Test For Male Fertility

New York 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?

$24.55

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $24.55 for this service. The price depends on where it is billed: about $17.38 from a physician practice, and about $54.95 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 8 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$17.38$6.31 to $25.12
FacilityA hospital or hospital-owned outpatient department$54.95$32.36 to $74.13

How much rates vary

Facilitymedian $55 · 10th to 90th $26 to $87Professionalmedian $17 · 10th to 90th $4 to $27
$5$10$20$50$100facility $55professional $17

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
$25.70
Median
$56.23
Typical High
$87.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$17.38
Typical High
$26.92
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$23.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$44.67
Typical High
$79.43
Cigna
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$151.36
Typical High
$151.36
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$52.48
Typical High
$120.23
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$19.05
Typical High
$61.66
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$26.92
Typical High
$35.48
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$40.74
Median
$60.26
Typical High
$50,118.72
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$30.20
Typical High
$64.57
United
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$31.62
Typical High
$39.81
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$19.05
Typical High
$45.71
Univera
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$32.36
Typical High
$36.31
Univera
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$30.20
Typical High
$36.31

Where New York 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 York· 41st of 51

$24.55

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.