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Utah rates for HCPCS A4290

Sacral nerve stimulation test lead, each

Facilitymedian $58 · 10th–90th $58–$580%50%100%$58Professionalmedian $58 · 10th–90th $58–$580%50%$58$50.0$100.0

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
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
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $63.10 / $104.71