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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 July 2026.

Facilitymedian $107 · 10th–90th $107$1070%50%100%$107Professionalmedian $107 · 10th–90th $69$1100%20%40%10th90th$107$5.0$10.0$20.0$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
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$107.15
Typical High
$109.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$151.36
Typical High
$186.21