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South Carolina 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
$21.88 / $77.62 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $25.12 / $34.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $33.88 / $44.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $77.62 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $45.71
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $26.92 / $38.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $31.62 / $38.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $19.05 / $34.67