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Arizona rates for HCPCS G0455

Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $3,090.30 / $6,309.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $4,365.16 / $7,943.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.10 / $114.82 / $208.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.69 / $41.69 / $89.13