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Michigan rates for HCPCS A4100

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

Facilitymedian $91 · 10th–90th $91–$2950%50%90th$91Professionalmedian $93 · 10th–90th $66–$1230%10%20%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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $91.20 / $123.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $162.18
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $131.83 / $346.74
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $117.49 / $158.49
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33