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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Maine 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 $126 · 10th–90th $81$2510%10%20%10th90th$126$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$75.86
Median
$87.10
Typical High
$120.23
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$181.97
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$190.55
Typical High
$363.08
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$93.33
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$181.97
Typical High
$363.08