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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

New Hampshire 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?

$141

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $141 for this service. Most negotiated rates run $102 to $214.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $93 · 10th to 90th $93 to $132Professionalmedian $141 · 10th to 90th $83 to $295
$10$100$1Kfacility $93professional $141

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
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$131.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$93.33
Typical High
$112.20
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$213.80
Typical High
$323.59
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$208.93
Typical High
$354.81
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$2,884.03
Median
$2,884.03
Typical High
$3,981.07

Where New Hampshire 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.

New Hampshire· 3rd of 51

$141

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.