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Fecal Microbiota Preparation and Instillation

Washington rates for HCPCS G0455

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

Rates data updated July 2026.

Facilitymedian $200 · 10th–90th $76$4,5710%5%10th90th$200$50.0$200.0$1.0K$5.0K$20.0K

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
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$2,511.89
Typical High
$17,782.79
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$2,818.38
Typical High
$5,011.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$165.96
Typical High
$831.76
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$245.47
Typical High
$257.04
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$177.83
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$2,754.23
Typical High
$4,897.79
United
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$3,467.37
Typical High
$6,309.57