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Fecal Microbiota Preparation and Instillation

Montana rates for HCPCS G0455

Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen

Rates data updated July 2026.

Facilitymedian $141 · 10th–90th $76$2570%20%10th90th$141$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$208.93
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$213.80
Typical High
$245.47
Providence
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$123.03
Typical High
$245.47