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Arizona rates for HCPCS A4290

Sacral nerve stimulation test lead, each

Facilitymedian $162 · 10th–90th $60–$6310%5%10%10th90th$162Professionalmedian $58 · 10th–90th $58–$690%50%90th$58$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$57.54 / $57.54 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $208.93 / $676.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $147.91 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $10.23 / $12.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $60.26 / $117.49
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $63.10 / $104.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $63.10 / $104.71