Sacral nerve stimulation test lead

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Sacral nerve stim test lead

Payers reporting HCPCS A4290

Payer pricing summary

Low

Average

$548

Median

$499

High

$1.6k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +14 other terms	84	$500	$402	$182	45%	—	$63 – $530
2	Blue Cross Blue Shield facility · fee schedule · outpatient · +8 other terms	44	$157	$280	$303	108%	—	$0 – $1.1k
3	MultiPlan facility · percent of total billed charges · bothfrom % of charges · +7 other terms	33	$1.0k	$1.1k	$364	33%	—	$544 – $2.1k
4	Aetna Better Health fee schedule · outpatient · +1 other terms	32	$530	$492	$129	26%	—	$59 – $588
5	Medical Mutual facility · percent of total billed charges · bothfrom % of charges · +1 other terms	31	$939	$890	$277	31%	—	$390 – $1.3k
6	Molina fee schedule · outpatient · +5 other terms	31	$515	$508	$11	2%	—	$490 – $530
7	Aetna fee schedule · outpatient · +14 other terms	30	$71	$155	$158	102%	—	$58 – $490
8	Phcs facility · percent of total billed charges · bothfrom % of charges · +1 other terms	28	$1.0k	$985	$218	22%	—	$544 – $1.3k
9	Excellus facility · percent of total billed charges · bothfrom % of charges	25	$798	$898	$475	53%	—	$285 – $2.2k
10	Carefirst facility · percent of total billed charges · bothfrom % of charges	24	$715	$853	$525	62%	—	$285 – $2.2k
11	Premera facility · percent of total billed charges · bothfrom % of charges	23	$746	$882	$551	62%	—	$285 – $2.2k
12	Regence facility · percent of total billed charges · bothfrom % of charges	23	$682	$855	$543	64%	—	$285 – $2.2k
13	Kaiser facility · percent of total billed charges · bothfrom % of charges · +2 other terms	18	$680	$706	$272	38%	—	$130 – $1.1k
14	Anthem facility · case rate · outpatient · +11 other terms	15	$15	$17	$4	23%	—	$10 – $26
15	Caresource facility · case rate · outpatient · +4 other terms	15	$16	$17	$4	23%	—	$10 – $27
16	Medcost facility · percent of total billed charges · bothfrom % of charges · +1 other terms	14	$747	$844	$185	22%	—	$532 – $1.1k
17	Bcbs Tx fee schedule · outpatient · +2 other terms	13	$490	$496	$7	1%	—	$490 – $515
18	Oscar facility · percent of total billed charges · bothfrom % of charges · +1 other terms	13	$464	$543	$132	24%	—	$369 – $823
19	Wellmark fee schedule · both · +2 other terms	13	$22	$27	$30	111%	—	$22 – $210
20	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$452	$287	$251	87%	—	$0 – $566
21	Amerihealth Caritas facility · percent of total billed charges · bothfrom % of charges · +1 other terms	11	$1.4k	$1.2k	$467	40%	—	$337 – $1.6k
22	Optum facility · case rate · outpatient · +5 other terms	11	$14	$16	$4	22%	—	$13 – $24
23	Highmark fee schedule · outpatient · +3 other terms	10	$277	$277	—	—	—	$277 – $277
24	Magellan facility · percent of total billed charges · bothfrom % of charges · +1 other terms	9	$800	$905	$607	67%	—	$337 – $2.2k
25	Medica fee schedule · both · +4 other terms	9	$140	$140	—	—	—	$140 – $140

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