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Minnesota 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
$68.69 / $130.77 / $2,042.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$342.30 / $1,462.23 / $3,247.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$291.14 / $464.64 / $1,117.74
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.92 / $409.66 / $880.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.75 / $163.54 / $364.82