go back

Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Washington, DC 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 October 2026.

How much does Nonsheet Skin Substitute, FDA-Cleared, Unclassified cost?

$107

Typical negotiated rate. In Washington, DC, October 2026.

Insurers have agreed to pay about $107 for this service. Most negotiated rates run $102 to $107.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $107 · 10th to 90th $107 to $107Professionalmedian $107 · 10th to 90th $93 to $107
$5$10$20$50$100facility $107professional $107

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Aetna
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$107.15
Typical High
$107.15
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$34.67
Median
$53.70
Typical High
$53.70
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$18.62
Median
$21.38
Typical High
$21.38
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$14.13
Median
$15.85
Typical High
$15.85
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$9.33
Median
$10.72
Typical High
$10.72
Cigna
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$151.36
Typical High
$186.21

Where Washington, DC sits

The same service costs 83.2 times more in North Dakota than in Kansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington, DC· 23rd of 51

$107

ND $251KS $3.02

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.