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New Mexico 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
$98.14 / $2,145.78 / $7,838.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.32 / $684.01 / $1,145.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.73 / $93.73 / $93.73
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.35 / $102.52 / $158.96