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New York 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
$26.92 / $60.26 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $23.99 / $30.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.37 / $4.37 / $23.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $50.12 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $151.36 / $151.36
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $52.48 / $120.23
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $19.05 / $61.66
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $30.20 / $35.48
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $60.26 / $50,118.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $28.18 / $38.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $19.05 / $47.86
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $32.36 / $36.31
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $30.20 / $36.31