Cost for infertility
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Estimate of Labs for One Cycle IVF and/or Oocyte Donor Program
Case example from Duke University Health System on 8/15/06.
Typically, the following tests must be received before beginning medications.
Name of Lab Test: Semen Profile (Partner), CPT Code: CM062, Cost: $605.00
Screening Labs: (Name of Lab Test, CPT Code, Cost)
HIV, 86701, $145.00
Hepatitis B, 87340, $85.50
Hepatitis C, 86803, $124.00
VDRL/RPR, 86592, $51.00
Rubella (female only), 86762, $79.50
Cystic Fibrosis, 269EX, $516.00
Cystic Fibrosis Interp., 83912, $47.00
Progesterone, 84144, $124.00
Estradiol, 82670, $210.50
HCG Pregnancy Test, 84702, $120.00
LH, $143.00
Type & Screen, 86885, $187.25
FSH, $133.00
ABC, $73.00
OP7, $185.00
Testosterone Total Serum, $152.00
Estimate of Therapeutic Donor Insemination
Case example from Duke University Health System on 8/15/06.
Name of Lab Test, CPT Code, Cost
Initial Consultation, 99244, $290.00
HIV, 86701, $145.00
Hepatitis B Surface Antigen, 87340, $85.50
Hepatitis C Core Antibody, 86803, $124.00
Rubella Titer,86762, $79.50
CMV Immune Status, 86644, $86.00
Blood Type & Screen, 86885, $187.25
Toxoplasmosis, 86777, $100.00
VDRL (STS), 86592, $51.00
PAP Smear, $66.00
OP Phelbotomy Charge, $26.00
Intrauterine or Cup Insemination, 58322, $260.00
Sperm Washing (if needed),CM064, $287.00
Sperm Prep (prewashed specimens), 89353, $130.00
DONOR SPERM SPECIMENS: For sperm bank, price varies with type of specimen, but usually average $225 per specimen plus shipping costs. Sperm is purchased by the patient and will be shipped to Duke. THERE IS AN ANNUAL STORAGE FEE OF $200.00 PER CANE THAT IS BILLED EACH YEAR EACH CANE WILL STORE 5 SPECIMENS.
Estimate of Frozen Embryo Transfer
Case example from Duke University Health System on 8/15/06.
Name of Lab Test, CPT Code, Cost
PHYSICIAN, 58974, $700.00
GAMETE TRANSFER LAB, 89255, $770.00
THAWING EMBRYO, 89352, $200.00
Estimated Costs for Controlled Ovarian Hyperstimulation and Intrauterine Insemination
Per cycle case example from Duke University Health System on 8/15/06.
Charge, CPT Code, Description
$354.00 each 76857 Ultrasound
$210.50 each 82670 Estradiol
The acutal number of visits will vary according to the individual needs of the patient. 1 baseline ultrasound and at least 3 monitoring ultrasounds.
If you are having an intrauterine insemination as part of your therapy, the following charges will occur on the day of insemination:
Charge, CPT Code, Description
$260.00 58322 Intrauterine Insemination
$287.00 89260 Sperm Washing
The diagnosis code used for each visit will be based on your condition (e.g. endometriosis, tubal factor infertility, unexplained infertility, etc.) The treatment itself is suggestive of infertility regardless of diagnosis code used.
After starting your medications you will be seen around day seven to nine for monitoring. Each cycle will require approximately three to four visits for monitoring.
For the monitoring visits, you will incur physician monitoring fees and estradiol fees.
For patients undergoing intrauterine insemination, you will incur a fee for sperm washing in addition to the insemination charge.
Estimate of Charges for One Cycle of IVF and ICSI
Case example from Duke University Health System on 7/7/06.
CPT Code, IVF, ICSI
1. MONITORING PHASE OF THE PROGRAM
The actual number of visits will vary according to the individual needs of the patient.
1 baseline ultrasound and at least 4 monitoring ultrasounds.
package price 4 ultrasounds $354.00 76857 $1,416.00 $1,416.00
package price 4 estradiols $210.50 8267 $842.00 $842.00
2. OOCYTE (EGG) ASPIRATION
Included in this fee:
physician's fee, 58970 $3,100.00 $3,100.00
conscious sedation, Recovery unit and OR medication.
Ultrasonic guidance aspiration 76948 $147.00 $147.00
3. OOCYTE CULTURE
Oocyte Culture 89250 $2,014.00 $2,014.00
Extended culture of oocytes 89272 $650.00 $650.00
ICSI #1(less than or equal to 10) 89280 N/A $1,591.00
ICSI #2(greater than 10) 89281 N/A $1,791.00
4. EMBRYO TRANSFER
Physician 58974 $700.00 $700.00
Gamete Transfer Lab 89255 $770.00 $770.00
5. MISCELLANEOUS
IVF Administrative Fee * W0314 $300.00 $300.00
Cryopreservation * 89258 $794.00 $794.00
Sperm Prep * 89353 $130.00 $130.00
ASSISTED HATCHING (optional) 89253 $1030.00 ZIFT (optional) 58976 $2956.00
THIS ESTIMATE OF CHARGES DOES NOT INCLUDE THE COST OF MEDICATIONS OR BLOOD WORK FOR THE MONITORING PHASE OR FOLLOW UP VISITS.
After starting your medications you will be seen around day seven to nine for monitoring. Each cycle will require approximately three to four visits for monitoring. For the monitoring visits, you will incur physician monitoring fees and estradiol fees.
Also note there is a difference in charges between a day two or three transfer and a day six transfer when undergoing IVF cycles.
Estimate of Charges for One Cycle of the Oocyte Donor Program
Case example from Duke University Health System on 7/7/06.
DONOR'S ESTIMATED CHARGES
MONITORING PHASE
The actual number of visits will vary according to the individual needs of the patient.
Estradiol @ $210.50 82670 $842.00 package
1 baseline ultrasound and @ 3 monitoring ultrasounds. Ultrasounds @ 354.00 each 76 76857 $1,416.00 package
OOCYTE (EGG) RETRIEVAL
Included in the fee: physician's fee Physician 58970 $3,100.00
Conscious sedation, recovery unit and OR medications.
Ultrasonic guidance aspiration 76948 $147.00
SCREENING OF DONOR W0341 $1,200.00
ADMINISTRATIVE FEE (each cycle) W0340 $709.00
DONOR MEDICATIONS (estimate)
Cost will vary depending on amount of Depot Lupron 1 Kit TOTAL $3,000.00 medication used. Medications will be Repronex 30 amps. HCG 10,000u 1 Vial reference only and is not included in the deposit.
DONOR COMPENSATION $2,500.00
RECIPIENT'S ESTIMATED CHARGES
MONITORING PHASE Baseline Ultrasound 76857 $354.00
OOCYTE (EGG) CULTURE
Oocyte Culture (CM060) 89250 $2,014.00
Extended culture oocytes 89272 $650.00
insurance may not cover Cryopreservation (CM058) 89258 $794.00
insurance may not cover Sperm Prep 89353 $130.00
ICSI #1 less than 10) 89280 $1,591.00
ICSI #2 greater than 10 89281 $1,791.00
EMBRYO TRANSFER
Physician 58974 $700.00
Gamete Transfer Lab 89255 $770.00
ESTIMATED DEPOSIT REQUIRED
Standard Cycle IVF $13,300.00
IVF with ICSI $15,000.00
This estimate of charges does not include the cost of medications for the donor or recipient, they are billed by the pharmacy. THIS DOES NOT INCLUDE BLOOD WORK FOR THE RECIPIENT.
You will be seen for your initial evaluation and coordination of a donor profile. Once a donor has been selected, she will be seen around day seven to nine for monitoring. Each cycle will require approximately three to four visits for monitoring. For the monitoring visits, you will incur physician monitoring fees and estradiol fees.
Your medications will be an additional charge, but you will not require monitoring for yourself. The charges are very similar to an IVF cycle but the example above should help you understand the charges. Also note there is a difference in charges between a day two transfer and a day six transfer when undergoing IVF or donor cycles.
Categories: Assisted reproductive technology Categories: Pregnancy Categories: Fertililty
