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Washington rates for HCPCS 89261

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

Facilitymedian $151 · 10th–90th $89–$2040%20%10th90th$151Professionalmedian $105 · 10th–90th $81–$2950%20%10th90th$105$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
$89.13 / $151.36 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $104.71 / $295.12
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $144.54 / $295.12
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $114.82 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $104.71 / $131.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $144.54 / $295.12
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $194.98 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $16.22 / $26.92
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $57.54