go back

Massachusetts 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
$67.48 / $1,823.00 / $3,363.00
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$361.79 / $361.79 / $361.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.09 / $102.93 / $183.75
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.17 / $109.53 / $8,090.00
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$361.79 / $361.79 / $361.79