go back

Nonsheet Skin Substitute, FDA-Cleared, Unclassified

North Dakota 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 $112 · 10th–90th $87$1120%50%10th$112Professionalmedian $87 · 10th–90th $69$1350%20%10th90th$87$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
$87.10
Median
$112.20
Typical High
$112.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$87.10
Typical High
$112.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$186.21
Medica
Setting
Facility
Modifier
Global
Typical Low
$3.02
Median
$5.13
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$245.47
Typical High
$398.11