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New York 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
$83.18 / $131.83 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $91.20 / $389.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $33.11 / $64.57
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $120.23 / $120.23
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $120.23 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.98 / $67.61 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $131.83 / $426.58
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $151.36 / $245.47
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $24.55 / $66.07
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $154.88 / $154.88
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50,118.72 / $53,703.18 / $75,857.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $117.49 / $151.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $104.71 / $117.49
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.33 / $16.22 / $27.54
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $100.00 / $154.88