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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
$25.83 / $55.30 / $90.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.22 / $17.22 / $26.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.41 / $4.41 / $21.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.92 / $66.76 / $110.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.34 / $45.43 / $152.31
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.60 / $66.36 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.64 / $18.64 / $59.09
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.79 / $30.02 / $35.49
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.92 / $66.84 / $597.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.54 / $31.60 / $65.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.27 / $18.96 / $47.40
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.27 / $36.34 / $36.34
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.79 / $30.02 / $37.97