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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Montana 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.

How much does Nonsheet Skin Substitute, FDA-Cleared, Unclassified cost?

$75.86

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $75.86 for this service. Most negotiated rates run $57.54 to $107.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $170 · 10th to 90th $5 to $81,283Professionalmedian $76 · 10th to 90th $3 to $126
$10$100$1K$10K$100Kfacility $170professional $76

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$75.86
Typical High
$125.89
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Providence
Setting
Facility
Modifier
Global
Typical Low
$3.02
Median
$120.23
Typical High
$281.84
Providence
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$125.89

Where Montana sits

The same service costs 2.6 times more in Alaska than in Mississippi. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 48th of 51

$75.86

AK $182MS $69.18

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.