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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Indiana 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 $69$1070%50%10th$107Professionalmedian $83 · 10th–90th $51$1100%20%10th90th$83$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
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$107.15
Typical High
$107.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$81.28
Typical High
$109.65
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$125.89
Typical High
$295.12
CareSource
Setting
Facility
Modifier
Global
Typical Low
$41,686.94
Median
$41,686.94
Typical High
$63,095.73
Cigna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$239.88