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Idaho 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
$63.35 / $117.39 / $4,500.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.62 / $110.86 / $161.75
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,039.75 / $1,853.08 / $2,769.18