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West Virginia 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
$46.88 / $82.80 / $1,200.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.69 / $74.69 / $90.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.73 / $93.73 / $93.73