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Montana rates for HCPCS G0429

Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (LDS) (e.g., as a result of highly active antiretroviral therapy)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.57 / $85.55 / $515.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.26 / $119.00 / $163.55
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.74 / $125.24 / $184.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.86 / $162.84 / $177.41