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West Virginia 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
$25.12 / $47.86 / $47.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $25.12 / $36.31
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $50.12 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $151.36 / $151.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $19.05 / $19.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $14.13 / $31.62