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Minnesota rates for HCPCS A4290

Sacral nerve stimulation test lead, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $57.54 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $57.54 / $57.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $588.84 / $1,412.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $141.25 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.38 / $33.11 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.23 / $11.75 / $12.88
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $33.88 / $70.79
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.23 / $10.23 / $13.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $57.54 / $104.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $69.18 / $117.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $69.18 / $154.88