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Utah rates for HCPCS 89264

Sperm identification from testis tissue, fresh or cryopreserved

Facilitymedian $1,778 · 10th–90th $100–$2,3440%20%10th90th$1,778Professionalmedian $302 · 10th–90th $282–$3470%50%10th90th$302$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$100.00 / $1,778.28 / $2,344.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $346.74
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
$109.65 / $109.65 / $138.04
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $104.71 / $158.49
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $181.97 / $181.97