go back

Utah rates for HCPCS G0455

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

Facilitymedian $3,020 · 10th–90th $132–$4,5710%10%10th90th$3,020Professionalmedian $166 · 10th–90th $89–$2510%10%20%10th90th$166$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $3,019.95 / $4,570.88
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,778.28 / $2,754.23
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $165.96 / $251.19