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Minnesota rates for HCPCS A4100

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

Facilitymedian $389 · 10th–90th $87–$9330%10%10th90th$389Professionalmedian $107 · 10th–90th $87–$1480%20%10th90th$107$1.0$5.0$20.0$100.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $93.33 / $123.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $125.89 / $125.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $107.15 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $162.18 / $186.21
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $436.52 / $933.25
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $158.49
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.02 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $263.03 / $389.05