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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Arizona rates for HCPCS A4100

Nonsheet form skin substitute, FDA-cleared as a device, not otherwise specified (list in addition to primary procedure)

Rates data updated July 2026.

Facilitymedian $87 · 10th–90th $3$3090%5%10th90th$87Professionalmedian $98 · 10th–90th $3$1320%10%10th90th$98$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$3.02
Median
$3.02
Typical High
$3.02
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$93.33
Typical High
$125.89
BCBS
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$97.72
Typical High
$331.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$134.90
Typical High
$234.42
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Medica
Setting
Facility
Modifier
Global
Typical Low
$3.02
Median
$3.31
Typical High
$6.46
United
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$134.90
Typical High
$190.55