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Idaho rates for HCPCS A4100

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

Facilitymedian $123 · 10th–90th $72–$2570%20%10th90th$123Professionalmedian $107 · 10th–90th $65–$1860%10%10th90th$107$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $97.72 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $190.55 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $144.54 / $269.15
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $218.78 / $251.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $190.55 / $239.88
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88