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Utah rates for HCPCS 89261

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

Facilitymedian $447 · 10th–90th $81–$5750%20%10th90th$447Professionalmedian $89 · 10th–90th $81–$1070%50%10th90th$89$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $446.68 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $89.13 / $107.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $131.83
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $104.71 / $158.49
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $34.67 / $34.67
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $53.70 / $53.70