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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
$1,170.00 / $2,771.00 / $6,305.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,660.00 / $6,198.03 / $10,860.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.09 / $116.42 / $209.19