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Illinois 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
$133.32 / $1,363.00 / $5,389.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$466.27 / $1,206.98 / $1,663.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.73 / $93.73 / $93.73
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.06 / $177.58 / $836.50
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00