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Indiana 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
$66.67 / $121.62 / $5,634.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.21 / $54.21 / $104.63
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.73 / $70.44 / $79.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.73 / $93.73 / $93.73