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Oklahoma 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
$25.12 / $31.62 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $23.99 / $30.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $20.42 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $45.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $24.55 / $104.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $13.18 / $31.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $31.62 / $38.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $13.18 / $19.05