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Tennessee 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
$131.94 / $2,133.00 / $6,681.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.73 / $93.73 / $93.73
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$361.79 / $361.79 / $361.79