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North Carolina 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
$69.36 / $903.00 / $5,449.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.73 / $93.73 / $93.73
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.36 / $105.70 / $169.12
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$361.79 / $361.79 / $361.79