Kofinas Fertility Group

Finance Form #11D.1 — Treatment Fees (Oxford / UHC)

Revised 04/22/24 · CD
Prepared for personal records

IVF Treatment Cost Breakdown

A plain-language summary of the fee schedule for one IVF retrieval cycle, based on Finance Form #11D.1. Figures reflect list prices before insurance adjustment — actual out-of-pocket cost depends on your specific coverage and how the cycle unfolds.

Base cost — one retrieval, no add-ons

$6,300.00

Facility fee for in-vitro fertilization. This is the minimum committed cost before any biopsy, genetic testing, or cryopreservation is added.

Due at cycle start$5,200.00

Due at retrieval (to MRSC)$1,100.00

Combined benefits available$100,000

01 Facility & Retrieval

The core fee for the retrieval cycle itself, split across two payments to two different parties.

Item	Amount
Facility fee — 1 retrievalTotal fee for the IVF cycle facility charge	$6,300.00
↳ Due upon start of cycle Due now	$5,200.00
↳ Balance paid directly to surgical center (MRSC), day of retrieval Paid to MRSC	$1,100.00

02 Embryo Biopsy (PGT)

Preimplantation genetic testing biopsy fee, billed per cycle. First cycle costs more than any repeat cycle.

Item	Amount
Preimplantation embryo biopsy — first cycle	$3,000.00
Preimplantation embryo biopsy — any subsequent cycle	$2,500.00

03 Genetics Lab — Cooper Genomics Paid directly to Cooper

PGT-A analysis is billed per embryo tested, separately from the clinic — paid straight to Cooper Genomics.

Item	Amount
PGT-A testingPer embryo tested	$270.00 / embryo
PGT transportation feeFlat fee, shipping embryo biopsy samples	$100.00

04 Cryopreservation & Storage

Only applies if embryos are frozen rather than transferred fresh. Storage is billed annually thereafter.

Item	Amount
Cryopreservation fee If embryos are frozenApplies to this cycle and any subsequent cycle resulting in frozen embryos	$1,250.00
Storage fee Annual, billed on receiptOut-of-network insurance may cover part; you're balance-billed for the rest	$1,250.00 / yr

05 Future Cycles & Transfers

Costs that only apply later — a subsequent frozen embryo transfer, another egg retrieval, or moving tissue between facilities.

Item	Amount
Facility fee per subsequent embryo transferEach additional transfer from this same retrieval	$3,000.00
New facility fee, any subsequent retrieval cycleBanking embryos or any other reason — priced as a new cycle (see Section 01)	See §01
Administrative fee — reproductive tissue transferred in/out of facility	$1,100.00

06 Your Coverage Stack

Two separate benefit pools, working in sequence — not in parallel. Together they cover $100,000, comfortably above both scenarios. The real risk isn't cost, it's a bill falling into a gap between the two.

Wife's benefit

$50,000

UnitedHealthcare / Oxford — medical insurance

Real insurance. The clinic bills UHC directly, UHC pays its share, you owe deductible/coinsurance. Requires prior authorization before the cycle starts.

Your benefit

$50,000

Carrot — employer reimbursement fund

Not insurance. You pay first, then submit itemized receipts and get reimbursed dollar-for-dollar. Designed to sit on top of insurance and absorb what it won't pay.

Get UHC prior authorization firstBefore any cycle starts. Without it, UHC can deny the whole cycle and everything lands on Carrot — burning your $50k on things insurance should have paid for.

Bill covered services to UHCCarrot's own guidance is to run care through insurance first where coverage exists, then use Carrot for what's left.

Collect the EOB for every claimThe Explanation of Benefits is what proves to Carrot that UHC denied or partially paid. Carrot reimburses residual out-of-pocket — deductible, coinsurance, denied line items.

Submit remainder to Carrot with itemized receiptsFor services UHC never covers (Cooper Genomics, storage), ask the clinic for the self-pay/cash rate instead — the form notes a discount for cash or certified check.

Carrot won't reimburse what UHC already paid, so the pools don't double up on the same dollar. What they do is cover different categories — and the split below is where the money actually lands.

Line item	Likely payer	Amount
Facility fee — egg retrieval UHCYou've confirmed retrievals are billable to UHC	Bill to insurance	$6,300.00
Embryo transfer facility fee UHCYou've confirmed transfers are billable to UHC	Bill to insurance	$3,000.00 ea.
Embryo biopsy (the procedure) ConfirmHinges on whether the underlying test is covered — see below	Ask UHC	$3,000 / $2,500
PGT-A analysis — Cooper Genomics CarrotUHC's medical policy treats PGT as medically necessary only for PGT-M (single-gene) or PGT-SR (structural rearrangement). Routine PGT-A aneuploidy screening generally falls outside that.	Self-pay → claim	$270 / embryo
PGT transportation fee CarrotPaid directly to Cooper, never runs through insurance	Self-pay → claim	$100.00
Cryopreservation fee ConfirmUHC policy does recognize freeze-all cryopreservation as part of a PGT cycle — worth pushing on	Ask UHC first	$1,250.00
Annual storage fee CarrotThe clinic's form states the lab is out of network with all insurances; you'll be balance-billed for whatever UHC doesn't pay	Self-pay → claim	$1,250.00 / yr
Second retrieval for banking ConfirmUHC's clinical guideline explicitly describes embryo banking/accumulation as not a covered benefit. Framing matters enormously here.	High denial risk	$6,300.00

07 Estimate Your Scenario

Toggle the variables that apply to your cycle to get a rough total. This does not include insurance reimbursement, taxes, or the cash-payment discount.

Facility fee (1 retrieval) $6,300.00

Biopsy cycle

# Embryos tested (PGT-A, $270 ea.)

PGT transportation fee

Embryos cryopreserved (+$1,250)

Storage, first year (+$1,250)

Estimated total $0.00

Against $100,000 in combined benefits — $0.00 would remain if every line item were covered by one pool or the other.
Split estimate: $0.00 billable to UHC · $0.00 to Carrot · $0.00 to confirm.

08 Two Sample Scenarios

Full cost projections for two paths, with each line item tagged by likely payer. Both assume embryos are frozen while awaiting genetic results, and that each PGT-A shipment carries its own transportation fee.

Scenario A

1 retrieval · 4 embryos tested · 3 transfers

Single egg retrieval, all 4 embryos sent for PGT-A, three separate frozen embryo transfers over time.

Facility fee — retrieval 1 UHC	$6,300.00
Biopsy — first cycle Confirm	$3,000.00
PGT-A — 4 embryos × $270 Carrot	$1,080.00
PGT transportation fee Carrot	$100.00
Cryopreservation fee Confirm	$1,250.00
Storage — year 1 Carrot	$1,250.00
Transfers — 3 × $3,000 UHC	$9,000.00

Estimated total $21,980.00

UHC $15,300 Carrot $2,430 Confirm $4,250

One retrieval cycle, so biopsy is billed at the "first cycle" rate only.
Cryo + storage charged once, for the single batch of frozen embryos.
Cleanest coverage story — one medically-indicated retrieval, no banking question to defend.

Scenario B

2 retrievals · 3 embryos tested each · 3 transfers

Two separate egg retrievals (e.g. for banking), 3 embryos tested from each batch, three total frozen embryo transfers.

Facility fee — retrieval 1 UHC	$6,300.00
Facility fee — retrieval 2 Confirm	$6,300.00
Biopsy — first cycle Confirm	$3,000.00
Biopsy — subsequent cycle Confirm	$2,500.00
PGT-A — 6 embryos × $270 Carrot	$1,620.00
PGT transport × 2 shipments Carrot	$200.00
Cryopreservation × 2 batches Confirm	$2,500.00
Storage — year 1 Carrot	$1,250.00
Transfers — 3 × $3,000 UHC	$9,000.00

Estimated total $32,670.00

UHC $15,300 Carrot $3,070 Confirm $14,300

Second retrieval billed as a new facility fee per the form's "subsequent retrieval cycle" rule.
Storage assumed as one combined annual fee for all frozen embryos — could be billed per batch.
$14,300 sits in the "confirm" bucket — over 3× Scenario A. If UHC denies the second retrieval as embryo banking, that $6,300 shifts to Carrot.

Scenario B costs $10,690.00 more in gross fees — but the sharper difference is exposure. Scenario A leaves $4,250 unresolved against coverage; Scenario B leaves $14,300. Both fit inside $100,000 of benefits with room to spare, so the decision is clinical, not financial.

09 Cost Per Cycle

The same money, viewed as a sequence rather than a lump sum. Cycle 1 carries the retrieval; every cycle after it is just a transfer from embryos you already have on ice.

Cycle 1

Retrieval + freeze + storage + first transfer Facility fee $6,300 · cryopreservation $1,250 · storage yr 1 $1,250 · transfer $3,000

$11,800

Cycle 1 + PGT

Same, with 4 embryos genetically tested Adds biopsy $3,000 · PGT-A 4 × $270 = $1,080 · transport $100 — a $4,180 uplift

$15,980

Cycle 2

One more transfer from the same batch Transfer facility fee only — no retrieval, no biopsy, no new testing

$3,000

Cycle 3+

Each further transfer Add $1,250 for each additional year the embryos stay in storage

$3,000

The cost is front-loaded. Cycle 1 with testing runs $15,980; each attempt after it is $3,000 — about 19% of the first. If a transfer fails, the financial cost of trying again is small relative to what you've already committed. Budget for cycle 1 as if it were the whole thing, and treat repeat transfers as marginal.

One ambiguity worth $3,000: the form charges the transfer facility fee for each subsequent transfer resulting from a retrieval. That wording leaves open whether the very first transfer is already bundled into the $6,300 retrieval fee. In a freeze-all PGT cycle the first transfer happens weeks later, so it may or may not count as "subsequent." Ask Kofinas directly — if the first transfer is included, every figure in this report drops by $3,000.

Storage is also modeled as a single year-1 charge throughout this report. It's billed annually for as long as embryos remain frozen, so a three-year gap between the first and last transfer adds $2,500 that isn't in these totals.

10 Questions to Confirm

Everything marked "confirm" above resolves with a few phone calls. Ask these before the cycle starts — the answers move thousands of dollars between pools.

Kofinas finance dept · (212) 348-4000

Is this fee schedule what I owe after Oxford/UHC pays, or does it get submitted to insurance first?

This is the single biggest unknown. The form is titled "Treatment Fees (Oxford/UHC)" and demands $5,200 at cycle start — which often signals these are patient-responsibility amounts on top of insurance, not charges awaiting reimbursement. If so, the entire report is Carrot-side, not UHC-side.

Kofinas finance dept

What is the cash / certified-check discount, and does using it forfeit insurance billing?

Self-pay rates are usually lower. If UHC coverage is thin, paying the discounted cash rate and claiming through Carrot may net out better than running it through insurance.

Kofinas finance dept

Is the first embryo transfer included in the $6,300 retrieval facility fee, or billed separately at $3,000?

The form charges $3,000 for each "subsequent" transfer, which implies the first may be bundled. In a freeze-all PGT cycle the first transfer is delayed by weeks, making its status unclear. Worth $3,000 per scenario.

UnitedHealthcare / Oxford member services

Is PGT-A covered under this plan, or only PGT-M and PGT-SR? And is the biopsy procedure covered separately from the analysis?

UHC's published medical policy limits PGT to single-gene and structural-rearrangement testing. If the biopsy is bundled with an uncovered PGT-A, the $3,000 biopsy fee likely lands on Carrot too.

UnitedHealthcare / Oxford

How many retrievals does the $50,000 cover, and is a second retrieval for embryo banking excluded?

UHC's clinical guideline describes embryo banking/accumulation as not covered, and some plans require using all frozen euploid embryos before authorizing another stimulation cycle. This is the $6,300 question in Scenario B.

UnitedHealthcare / Oxford

Is the $50,000 a lifetime maximum or annual? Does it include medications?

Fertility drugs aren't on this form at all and commonly run $3,000–$7,000 per cycle. They may draw from the same $50,000 or a separate pharmacy maximum.

Carrot care navigator

Is Kofinas Fertility Group a Carrot-eligible provider, and is Cooper Genomics eligible too?

Carrot only reimburses at approved providers. If Cooper isn't eligible, the PGT-A fees have no home in either pool.

Carrot care navigator

Does Carrot require an EOB showing UHC denial before reimbursing, or can I submit self-pay receipts directly?

Determines whether you must run every charge through insurance first — which affects whether you can take the cash discount.

Carrot care navigator

Can my benefit reimburse expenses incurred by my spouse as the patient?

Carrot benefits are typically per-employee with the spouse included, but the patient here is your wife while the benefit is yours. Worth confirming in writing before any spend.

11 Notes

Get insurance authorization before starting a cycle to avoid extra out-of-pocket costs if the cycle isn't approved. Finance Dept: (212) 348-4000.
Cooper Genomics is out-of-network with all insurance carriers — PGT-A and transportation fees are paid directly, not through the clinic.
Storage fees are only submitted to insurance if you carry out-of-network benefits; any unpaid portion is balanced-billed to you.
A discount applies when paying by cash or certified check (amount not specified on the form).
Not on this form: fertility medications, monitoring visits, anesthesia, and initial diagnostic workup. Medications alone commonly run several thousand dollars per cycle — budget for them separately.
Payer assignments above reflect UHC's published medical policies and Carrot's general reimbursement model, not your specific plan documents. Treat them as a starting hypothesis to verify, not a determination.