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Ohio rates for HCPCS A4100

Nonsheet form skin substitute, FDA-cleared as a device, not otherwise specified (list in addition to primary procedure)

Facilitymedian $3 · 10th–90th $1–$1260%20%40%10th90th$3Professionalmedian $91 · 10th–90th $3–$1230%20%10th90th$91$0.0$0.1$0.5$2.0$10.0$50.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $3.02 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $87.10 / $112.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $125.89 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $128.82 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40