Costs of Genetics and Advanced Sperm Testing

Genetics Testing Pricing for male infertility

As with hormone testing, genetics testing if also often covered by insurance since many genetic issues can also have general health implications.  Also, there is significant variation between labs in the price of these genetics tests.  Some labs charges extremely high prices for certain labs and then give a discount (like 50%) if the patient does not have insurance and is paying out-of-pocket.  Labs also sometimes have special low contracted prices either with certain insurance companies, or even with certain medical practices for their patients.

The ICD-10 diagnosis code that I typically use for hormone testing is E29.9

Below is a list of genetics test costs from a few labs- these are updated as of April 2017.  It contains a few national labs (such as Quest) as well as the special contract prices for patients of a certain female fertility clinic (LabCorp- contracted).  Reprosource is a specialty fertility testing company that offers testing nationwide.  For comparison, a local hospital (TriHealth) prices are also listed- both for no insurance (cash pay) pricing as well as the contracted rate for United Health Insurance.  

I have also included the CPT codes for the tests so that you can run them by your local lab and/or insurance company.

pricing of Sperm DNA Fragmentation Testing

The most common commercial form of sperm DNA testing is with testing the sperm DFI (DNA fragmentation index).  Currently, there are two companies which offer DFI testing to patients nationally.  Of note, some large research institutions offer in-house sperm DNA fragmentation testing (such as COMET and Tunel assays) with the costs for these tests varying among the different facilities.

CPT code: 88182

Reprosource

(www.reprosource.com)

DNA fragmentation testing is part of the Advanced Semen Report.   The cost of the Advanced Semen Report is $289.00 if self pay. The insurance list price is $578.00 with a non-covered cap of $317.90. Essentially, you can get the lower price ($289) if you self pay beforehand. If you decide to submit to your insurance, then the charge will be $578.00 which may be all or partially covered by your insurance, but if you have a large deductible then you may be responsible for up to this amount. If you submit and the insurance company rejects the claim, then you will owe $317.90.

The shipping and handling cost for a home collection of the specimen is $75, but this may be less if the sample is collected at a fertility center that performs routine semen analysis.

SCSA Diagnostics

(www.scsadiagnostics.com)

The DNA fragmentation index was developed by Dr. Evenson at SCSA diagnostics.  The cost for the SCSA test is $300 if not covered by insurance.  The shipping and handling cost for a home collection of the specimen is $150.