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Michigan 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
$71.53 / $2,056.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.58 / $104.58 / $104.58
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.32 / $2,056.00 / $4,933.00