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Utah 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
$53.70 / $79.43 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $89.13 / $89.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $138.04
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $109.65 / $147.91
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $112.20 / $173.78
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $125.89 / $173.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $89.13 / $131.83