go back

Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Oklahoma 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 October 2026.

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

$102

Typical facility fee. In Oklahoma, October 2026.

Insurers have agreed to pay about $102 for this service. Most negotiated rates run $77.62 to $102.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $78 · 10th to 90th $78 to $100Professionalmedian $102 · 10th to 90th $76 to $102
$5$10$20$50$100facility $78professional $102

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$77.62
Median
$77.62
Typical High
$77.62
Aetna
Setting
Professional
Modifier
None
Typical Low
$75.86
Median
$75.86
Typical High
$77.62
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$38.02
Median
$38.02
Typical High
$38.90
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$15.14
Median
$15.49
Typical High
$15.49
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$11.48
Median
$11.48
Typical High
$11.48
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$7.59
Median
$7.76
Typical High
$7.76
Cigna
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Medica
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00

Where Oklahoma sits

The same service costs 83.2 times more in North Dakota than in Kansas. 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.

Oklahoma· 34th of 51

$102

ND $251KS $3.02

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.