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Missouri rates for HCPCS A4100

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

Facilitymedian $100 · 10th–90th $3–$1410%20%10th90th$100Professionalmedian $98 · 10th–90th $66–$1290%10%10th90th$98$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
$3.09 / $100.00 / $141.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $87.10 / $125.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $109.65 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $144.54 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
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
$169.82 / $169.82 / $239.88