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Sacral Nerve Stimulation Test Lead

Rhode Island rates for HCPCS A4290

Sacral nerve stimulation test lead, each

Rates data updated July 2026.

Facilitymedian $105 · 10th–90th $105$2340%50%90th$105Professionalmedian $58 · 10th–90th $58$1050%50%90th$58$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$234.42
BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$104.71
Typical High
$104.71
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$104.71