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Sperm Readiness Test For Male Fertility

South Dakota 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?

$60.26

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $60.26 for this service. The price depends on where it is billed: about $60.26 from a physician practice, and about $36.31 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 6 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$60.26$24.55 to $75.86
FacilityA hospital or hospital-owned outpatient department$36.31$30.20 to $36.31

How much rates vary

Facilitymedian $36 · 10th to 90th $22 to $58Professionalmedian $60 · 10th to 90th $21 to $83
$20$50$100facility $36professional $60

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$21.88
Median
$36.31
Typical High
$36.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$24.55
Typical High
$24.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$60.26
Typical High
$75.86
Medica
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$30.20
Typical High
$151.36
Medica
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$16.22
Typical High
$38.02
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$74.13
Typical High
$87.10
United
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$38.02
Typical High
$38.02
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$19.05
Typical High
$41.69
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$31.62

Where South Dakota 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.

South Dakota· 1st of 51

$60.26

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.