go back

Michigan rates for HCPCS 89261

Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $72.44 / $91.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $89.13 / $281.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $13.49 / $13.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $13.49 / $13.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $104.71 / $131.83
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $194.98 / $234.42
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $89.13 / $123.03
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $104.71 / $104.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $87.10 / $165.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $26.92 / $26.92