go back

Washington 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
$89.13 / $151.36 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $91.20 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.70 / $114.82 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $104.71 / $131.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $131.83 / $239.88
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $239.88
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $154.88 / $295.12
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $34.67 / $34.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $194.98 / $354.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $16.22 / $26.92