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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 October 2026.

How much does Nonsheet Skin Substitute, FDA-Cleared, Unclassified cost?

$107

Typical negotiated rate. In Maine, October 2026.

Insurers have agreed to pay about $107 for this service. Most negotiated rates run $95.50 to $126.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $107 · 10th to 90th $87 to $162
$100$200professional $107

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$17.38
Median
$17.38
Typical High
$17.38
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$13.18
Median
$13.18
Typical High
$13.18
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$8.71
Median
$8.71
Typical High
$8.71
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$125.89
Typical High
$186.21
Cigna
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$245.47
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$17.38
Median
$17.38
Typical High
$17.38
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$13.18
Median
$13.18
Typical High
$13.18
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$8.71
Median
$8.71
Typical High
$8.71

Where Maine sits

The same service costs 83.2 times more in North Dakota than in Kansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maine· 25th of 51

$107

ND $251KS $3.02

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.