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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Minnesota 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 $417 · 10th–90th $126$1,0470%10%10th90th$417Professionalmedian $115 · 10th–90th $95$1820%20%10th90th$115$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
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$93.33
Typical High
$123.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1.00
Median
$125.89
Typical High
$234.42
BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$114.82
Typical High
$177.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$416.87
Typical High
$1,096.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$165.96
Typical High
$186.21
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$436.52
Typical High
$1,047.13
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$165.96
Medica
Setting
Facility
Modifier
Global
Typical Low
$3.02
Median
$100.00
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$263.03
Typical High
$389.05