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Wisconsin rates for HCPCS 89264

Sperm identification from testis tissue, fresh or cryopreserved

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $302.00 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $302.00 / $380.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $107.15 / $165.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $281.84 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $138.04 / $162.18
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $302.00 / $316.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $302.00 / $316.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $50.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $40.74 / $181.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $389.05