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Sperm Readiness Test For Male Fertility

Washington 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?

$31.62

Typical negotiated rate. In Washington, July 2026.

Insurers have agreed to pay about $31.62 for this service. The price depends on where it is billed: about $28.84 from a physician practice, and about $39.81 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 8 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$28.84$28.18 to $29.51
FacilityA hospital or hospital-owned outpatient department$39.81$31.62 to $72.44

How much rates vary

Facilitymedian $40 · 10th to 90th $32 to $141Professionalmedian $29 · 10th to 90th $13 to $34
$20$50$100$200facility $40professional $29

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
$29.51
Median
$72.44
Typical High
$173.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$29.51
Typical High
$29.51
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$39.81
Typical High
$87.10
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$28.18
Typical High
$34.67
Cigna
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$67.61
Typical High
$81.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$45.71
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$50.12
Typical High
$97.72
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$28.18
Typical High
$38.02
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$47.86
Typical High
$85.11
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$28.18
Typical High
$31.62
United
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$38.02
Typical High
$38.02
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$31.62
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$16.22
Typical High
$56.23

Where Washington 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.

Washington· 17th of 51

$31.62

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.