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INSURANCE
INFORMATION & PAYMENT POLICIES
Insurance
Information
We understand that insurance coverage is a complicated issue to
most couples. We encourage you to contact your insurance company
to discuss their specific payment policies. If you do not feel comfortable
with the information you have received or you do not understand
a payment policy please contact our Billing Office. We encourage
you to contact the billing office prior to the initiation of the
In Vitro Fertilization Cycle to discuss your financial obligations
and to assist you with any insurance questions you may have. We
will certainly work in cooperation with your insurance carrier to
insure that you will receive the benefits included in your policy.
Expenses not covered by your insurance policy will be your responsibility.
Please remember if your insurance carrier requires that you obtain a
referral for your visits at the Cooper Institute, you must maintain
current referrals. We suggest recording your referrals on a
Medical Calendar. This will help you to keep track of the number
of referrals you have and remind you to contact your primary doctor
when you need to update them. We appreciate your effort in assisting
us with this task. If you are uncertain if your referrals are current
you should contact our Billing Office (800) 752-1086 or by e-mail
at billing@ccivf.com. A
reminder: If you don’t have a current referral, you do not
have insurance reimbursement for a visit to Cooper Institute.
Payment
Policies
In an effort to maintain our reasonable prices for In Vitro Fertilization,
we must require that payment for all Egg Retrievals, Frozen Embryo
Transfers, Recipient of Donor Egg Transfer Cycles and all other
IVF procedures be received prior to the start of medication for
the IVF cycle (Lupron, Estrace, or injectable Fertility medications).
A delay in beginning your stimulation cycle may occur if payment
has not been received or if the Billing Office has not been contacted
by you in an effort to rectify your account.
Payment
Arrangements
CREDIT CARD:
We accept VISA, MasterCard, Discover. Contact the Billing Office
(856) 810-7740 or (800) 752-1086 with your credit card information.
PERSONAL CHECK OR MONEY ORDER:
Payment is accepted in all offices or you may mail the payment
directly to the Billing Office. The personal check or money order
should be made payable to COOPER INSTITUTE FOR REPRODUCTIVE HORMONAL
DISORDERS, P.C. Payment should be
mailed to:
COOPER INSTITUTE, P.C.
7447 OLD YORK ROAD
MELROSE PARK, PA 19027
ATTENTION: Billing Department
Costs for IVF
The following table reflects pricing for
a Full-Stimulation IVF cycle with retrieval and transfer.
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Stimulated In Vitro Fertilization Retrieval and Transfer Charges |
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(Estimate does not include medication costs) |
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CPT |
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Description of Service |
Code |
Fee |
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Retrieval |
Oocyte retrieval |
58970 |
1,200.00 |
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Oocyte retrieval ultrasonic guidance |
76948 |
200.00 |
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Oocyte identification from follicular fluid |
89254 |
400.00 |
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Insemination of oocytes |
89268 |
1,050.00 |
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Culture of oocyte(s) / embryo(s), less than 4 days |
89250 |
1,150.00 |
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Complex sperm wash with semen analysis |
89261 |
200.00 |
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4,200.00 |
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Transfer |
Preparation of embryo for transfer |
89255 |
500.00 |
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Assisted hatching |
89253 |
500.00 |
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Embryo transfer |
58974 |
1,050.00 |
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Embryo transfer ultrasonic guidance |
76942 |
200.00 |
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2,250.00 |
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Estimated Total Stimulated IVF Retrieval and Transfer Charges |
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6,450.00 |
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Female charges will be diagnosed with ICD9 628.9 (female
infertility) |
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The following table reflects pricing for a
Minimal-Stimulation
IVF cycle with retrieval and transfer. This is also known as
"Min-Stim IVF" or "IVF Lite"
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Minimal Stimulation
In Vitro Fertilization Retrieval and Transfer Charges |
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(Estimate does not include medication costs) |
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CPT |
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Description of Service |
Code |
Fee |
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Retrieval |
Oocyte retrieval |
58970ND |
600.00 |
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Oocyte retrieval ultrasonic guidance |
76948ND |
100.00 |
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Oocyte identification from follicular fluid |
89254ND |
200.00 |
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Insemination of oocytes |
89268ND |
525.00 |
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Culture of oocyte(s) / embryo(s), less than 4 days |
89250ND |
575.00 |
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Complex sperm wash with semen analysis |
89261ND |
100.00 |
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2,100.00 |
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Transfer |
Preparation of embryo for transfer |
89255ND |
250.00 |
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Assisted hatching |
89253ND |
250.00 |
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Embryo transfer |
58974ND |
525.00 |
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Embryo transfer ultrasonic guidance |
76942ND |
100.00 |
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1,125.00 |
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Estimated Total Natural Cycle IVF Retrieval and Transfer
Charges |
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3,225.00 |
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Female charges will be diagnosed with ICD9 628.9 (female
infertility) |
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The following table reflects pricing for a Frozen Embryo Transfer
only. This is done in cases where the patient either has
embryos in storage or is part of our Donor Embryo Program.
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Frozen Embryo Transfer |
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(Estimate does not include medication costs) |
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CPT |
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Description of Service |
Code |
Fee |
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Thawing of cryopreserved; embryo(s) |
89352 |
575.00 |
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FET |
Preparation of Embryo for Transfer (any method) |
89255 |
500.00 |
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Assisted hatching |
89253 |
500.00 |
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Embryo transfer |
58974 |
1,050.00 |
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Embryo transfer ultrasonic guidance |
76942 |
225.00 |
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Estimated Total Frozen Embryo Transfer Charges |
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2,850.00 |
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Female charges will be diagnosed with ICD9 628.9 (female
infertility) |
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Bloodwork and Ultrasound
Package |
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A Bloodwork and Ultrasound
Package includes 16 services; each set of bloods equals one
service. Each Ultrasound equals one service. |
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Blood-Only Package |
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680.00 |
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Ultrasound-Only Package |
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600.00 |
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*Package Bloods are limited
to the following testing: |
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Progesterone, Estradiol, LH,
FSH, P17 & Beta HCG |
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| Miscellaneous
Items: |
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| ICSI: less than or equal to 10 oocytes |
$1050.00 |
| ICSI: greater than 10 oocytes |
$1150.00 |
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| Anesthesia for Oocyte
Retrieval (billed by Cooper Anesthesia) |
$550.00 |
| Conscious Sedation |
$200.00 |
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| Cryopreservation of Embryo |
$300.00 |
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Embryo Storage - Quarterly Billing
(pt
must keep a valid credit card on file to be charged every 3
months) |
$125.00 |
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Embryo
Storage - Yearly Billing |
$500.00 |
Cryopreservation of Semen
Note: does not include long-term storage
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$250.00
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| New Patient Office Visit (Comprehensive) |
$350.00
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| Out-of-Town Management Fee (Per Cycle)
(IVF) |
$240.00 |
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Out-of-Town Management Fee - Pregnancy, One Time |
$375.00
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| PGD |
$4000.00 |
Do you or your patients have questions for billing? You are encouraged to contact them:
Melrose Park Billing Department: (800) 752-1086
New Jersey Billing Department: (856) 810-7740
Email Address: billing@ccivf.com
Prices valid as of
08-10-10. Subject to change without notice.
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