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Sperm Readiness Test For Male Fertility

Pennsylvania 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?

$26.92

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $26.92 for this service. The price depends on where it is billed: about $25.70 from a physician practice, and about $60.26 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$25.70$24.55 to $26.92
FacilityA hospital or hospital-owned outpatient department$60.26$38.02 to $79.43

How much rates vary

Facilitymedian $60 · 10th to 90th $27 to $112Professionalmedian $26 · 10th to 90th $19 to $32
$20$50$100facility $60professional $26

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
$26.92
Median
$60.26
Typical High
$112.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$25.70
Typical High
$29.51
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$24.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$22.91
Median
$43.65
Typical High
$109.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$45.71
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$18.62
Typical High
$45.71
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$31.62
Typical High
$54.95
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$37.15
Median
$66.07
Typical High
$112.20
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$25.70
Typical High
$93.33
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$77.62
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$31.62
Typical High
$31.62
United
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$31.62
Typical High
$38.02
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$19.05
Typical High
$47.86

Where Pennsylvania 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.

Pennsylvania· 27th of 51

$26.92

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.