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Massachusetts rates for HCPCS A4100

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $83.18 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $93.33 / $123.03
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $457.09 / $549.54
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $158.49 / $467.74
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $234.42 / $8,511.38
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $194.98 / $275.42
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $229.09 / $338.84
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $457.09 / $549.54
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $158.49 / $467.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $288.40 / $380.19