go back

Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Missouri 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 $100 · 10th–90th $3$1410%20%10th90th$100Professionalmedian $102 · 10th–90th $58$1350%10%10th90th$102$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
$3.09
Median
$100.00
Typical High
$141.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$81.28
Typical High
$125.89
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$109.65
Typical High
$134.90
BCBS
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$144.54
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Medica
Setting
Facility
Modifier
Global
Typical Low
$3.02
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$239.88