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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
$25.91 / $39.50 / $47.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.70 / $25.91 / $25.91
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $177.75 / $853.20
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.92 / $42.66 / $119,998.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.68 / $37.92 / $94.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.34 / $45.43 / $152.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.27 / $14.22 / $31.60