go back

Nonsheet Skin Substitute, FDA-Cleared, Unclassified

North Carolina 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 $117 · 10th–90th $87$2090%20%10th90th$117Professionalmedian $93 · 10th–90th $69$1170%20%40%10th90th$93$5.0$10.0$20.0$50.0$100.0$200.0$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
$117.49
Median
$117.49
Typical High
$117.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$97.72
Typical High
$117.49
BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$95.50
Cigna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Medcost
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$120.23
Typical High
$186.21
Medcost
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$208.93
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$288.40
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$691.83
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69