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Sacral Nerve Stimulation Test Lead

Michigan rates for HCPCS A4290

Sacral nerve stimulation test lead, each

Rates data updated July 2026.

Facilitymedian $58 · 10th–90th $22$2570%50%10th90th$58Professionalmedian $58 · 10th–90th $22$580%50%10th$58$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$57.54
Typical High
$57.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$22.39
Typical High
$22.39
BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$21.38
Typical High
$22.39
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$22.91
Typical High
$22.91
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$154.88
Typical High
$389.05
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$128.82
Typical High
$177.83
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$22.91
Typical High
$22.91
United
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
United
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$83.18
Typical High
$141.25