ABOVE KNEE SURGICAL STOCKING

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.

Generation details were not recorded for this description.

Original text from hospital filings

Above knee surgical stocking

Payers reporting HCPCS A4490

Payer pricing summary

Low

Average

$26

Median

$12

High

$136

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +7 other terms	71	$15	$23	$15	64%	—	$2 – $43
2	Aetna fee schedule · outpatient · +7 other terms	38	$5	$9	$8	93%	—	$2 – $31
3	UnitedHealthcare fee schedule · both · +8 other terms	26	$3	$5	$3	61%	—	$3 – $12
4	Blue Cross Blue Shield facility · fee schedule · outpatient · +6 other terms	20	$43	$56	$39	69%	—	$23 – $164
5	Cigna facility · fee schedule · outpatient · +4 other terms	18	$5	$6	$6	105%	—	$3 – $42
6	Anthem facility · case rate · outpatient · +5 other terms	15	$10	$11	$3	23%	—	$7 – $17
7	Caresource facility · case rate · outpatient · +1 other terms	15	$10	$11	$3	23%	—	$7 – $17
8	Molina facility · case rate · outpatient · +2 other terms	15	$10	$11	$3	23%	—	$7 – $17
9	Wellmark fee schedule · both · +1 other terms	13	$7	$8	$5	70%	—	$7 – $40
10	Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges	12	$43	$38	$10	26%	—	$13 – $46
11	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$72	$54	$31	57%	—	$23 – $90
12	Regence fee schedule · outpatient · +1 other terms	12	$5	$5	$1	26%	—	$4 – $13
13	Superior Healthplan facility · percent of total billed charges · outpatientfrom % of charges	12	$18	$19	$6	31%	—	$12 – $33
14	Optum facility · case rate · outpatient · +1 other terms	11	$10	$10	$2	22%	—	$9 – $15
15	Highmark fee schedule · outpatient · +2 other terms	10	$19	$19	—	—	—	$19 – $19
16	Medica fee schedule · outpatient · +4 other terms	10	$9	$9	$2	26%	—	$5 – $11
17	Aetna Better Health fee schedule · inpatient · +1 other terms	7	$2	$2	—	—	—	$2 – $2
18	Amerihealth Caritas professional · fee schedule · outpatient	3	$86	$87	$2	2%	—	$85 – $88
19	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$137	$143	$8	6%	—	$136 – $155
20	First Health professional · fee schedule · both · +2 other terms	3	$3	$3	—	—	—	$3 – $3
21	Bcbs Id facility · fee schedule · outpatient	2	$6	$6	$0	2%	—	$6 – $6
22	Kaiser fee schedule · both	2	$12	$12	—	—	—	$12 – $12
23	Tricare facility · fee schedule · outpatient	2	$22	$22	—	—	—	$22 – $22
24	Bcbs Il professional · fee schedule · both	1	$40	$40	—	—	—	$40 – $40
25	Bcbs La facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0

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