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Sperm Readiness Test For Male Fertility

Virginia 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?

$23.44

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $23.44 for this service. The price depends on where it is billed: about $23.44 from a physician practice, and about $41.69 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 7 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$23.44$13.18 to $26.92
FacilityA hospital or hospital-owned outpatient department$41.69$26.92 to $77.62

How much rates vary

Facilitymedian $42 · 10th to 90th $22 to $148Professionalmedian $23 · 10th to 90th $4 to $32
$5$10$20$50$100facility $42professional $23

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
$77.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$24.55
Typical High
$26.92
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$165.96
Typical High
$194.98
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$19.05
Cigna
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$77.62
Typical High
$162.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$36.31
Typical High
$45.71
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$38.02
Typical High
$46.77
Medcost
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$20.89
Typical High
$36.31
Medcost
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$25.70
Sentara
Setting
Facility
Modifier
Global
Typical Low
$21.88
Median
$36.31
Typical High
$79.43
Sentara
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$36.31
Typical High
$79.43
United
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$31.62
Typical High
$38.02
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$15.85
Typical High
$31.62

Where Virginia 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.

Virginia· 44th of 51

$23.44

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.