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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Michigan 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.

Facilitymedian $93 · 10th–90th $93$2950%50%90th$93Professionalmedian $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
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$93.33
Typical High
$123.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$162.18
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$131.83
Typical High
$346.74
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$117.49
Typical High
$158.49
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$154.88
Typical High
$154.88
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93