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Indiana rates for HCPCS A4100

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

Facilitymedian $107 · 10th–90th $107–$1070%50%$107Professionalmedian $93 · 10th–90th $56–$1170%20%10th90th$93$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$107.15 / $107.15 / $107.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $93.33 / $117.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $125.89 / $295.12
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41,686.94 / $41,686.94 / $63,095.73
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $239.88