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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.

How much does Nonsheet Skin Substitute, FDA-Cleared, Unclassified cost?

$87.10

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $89.13 from a physician practice, and about $3.02 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$89.13$69.18 to $107
FacilityA hospital or hospital-owned outpatient department$3.02$3.02 to $129

How much rates vary

Facilitymedian $3 · 10th to 90th $1 to $3,090Professionalmedian $89 · 10th to 90th $3 to $123
$0.1$1$10$100$1Kfacility $3professional $89

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
$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

Where Ohio 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.

Ohio· 34th of 51

$87.10

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.