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Tennessee 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
$22.91 / $25.12 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $23.99 / $36.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $31.62 / $31.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $64.57 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $38.02 / $47.86
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $151.36 / $151.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $21.88 / $31.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $19.05 / $31.62