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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Hawaii 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.

Professionalmedian $83 · 10th–90th $3$1580%10%10th90th$83$5.0$10.0$20.0$50.0$100.0$200.0

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
Professional
Modifier
Global
Typical Low
$3.02
Median
$75.86
Typical High
$123.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$173.78
Typical High
$218.78