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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Ohio 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 $3 · 10th–90th $1$3,0900%20%10th90th$3Professionalmedian $89 · 10th–90th $3$1230%20%10th90th$89$0.0$0.2$2.0$20.0$200.0$2.0K

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
$1.00
Median
$3.02
Typical High
$3,090.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$83.18
Typical High
$109.65
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$125.89
Typical High
$190.55
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
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$131.83
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$128.82
Typical High
$269.15
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$275.42
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40