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Sperm Readiness Test For Male Fertility

Utah 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 June 2026.

Facilitymedian $151 · 10th–90th $28$2000%20%10th90th$151Professionalmedian $25 · 10th–90th $18$320%20%10th90th$25$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$151.36
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$25.12
Typical High
$30.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$33.11
Typical High
$87.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$45.71
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$36.31
Typical High
$38.02
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$26.92
Typical High
$28.18
Select Health
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$31.62
Typical High
$31.62
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$27.54
Typical High
$31.62
United
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$15.85
Typical High
$20.42
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$31.62