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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Maryland 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 $93 · 10th–90th $69$1170%10%10th90th$93$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
$67.61
Median
$85.11
Typical High
$117.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$154.88
Typical High
$204.17
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$239.88
Typical High
$245.47
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$181.97
Typical High
$204.17